While today’s elections include several landmark statewide initiatives ranging from marriage equality to marijuana legalization, five states have also tacked purely symbolic measures onto their ballots purely to oppose Obamacare.

The Washington Post’s Sarah Kliff notes that — despite federal law’s supremacy over state law, and despite the fact that the Supreme Court upheld Obamacare’s constitutionality this summer — five states’ ballots include measures to invalidate Obamacare provisions. Wyoming’s Amendment A, Florida’s Amendment 1, Alabama’s Amendment 6, and Montana’s Measure LR-122 would all prohibit state residents and employers from being forced to purchase insurance or participate in any externally-imposed health care system. In Missouri, Proposition E seeks to prevent the state from instituting its own health insurance exchange.

But even if any of the first four measures to amend those states’ constitutions passed, all Americans would still be subject to federal Obamacare provisions, including the individual and employer mandates. And Obamacare already accounts for states that choose not to create their own statewide exchanges by requiring the federal government to set up “federally-facilitated exchanges” for them in 2014.

All five initiatives are totally ineffective, amounting to little more than political posturing against President Obama’s health reform law.

Mitt Romney repeatedly slammed Obamacare during the first presidential debate Wednesday night, asserting that while his own Massachusetts health reform law was an innovative way to insure Americans, Obamacare is an overreach and “government takeover” of health care. Attempting to tack to the center in the final month of the presidential campaign, Romney made a series of contradictory claims about his health care plan in order to make it seem as appealing as possible to voters.

But he repeatedly ran afoul of his own past statements and widely accepted policy realities, cherry-picking the most popular consumer protections that Romneycare shares with Obamacare while appealing to his conservative base and distancing himself from the law as a whole.

Here are six instances when Romney embraced provisions of the law he also promised to repeal:

– First of all, I like the way we did [health reform] in Massachusetts.

– Let — well, actually — actually it’s — it’s — it’s a lengthy description, but number one, pre-existing conditions are covered under my plan.

– Number two, young people are able to stay on their family plan. That’s already offered in the private marketplace; you don’t have — have the government mandate that for that to occur.

– And what we did in Massachusetts is a model for the nation, state by state.

– The federal government taking over health care for the entire nation and whisking aside the 10th Amendment, which gives states the rights for these kinds of things, is not the course for America to have a stronger, more vibrant economy.

– We’ll put in place the kind of principles that I put in place in my own state and allow each state to craft their own programs to get people insured.

Notice that Romney suggests that his plan will protect consumers by imposing government mandates, and then he proceeds to slam Obamacare for imposing government mandates.

This is not the first time that Romney has held up the consumer protections in his reform law as a potential archetype for the nation, and while he has a lengthy history of heralding Obamacare’s individual mandate as a creative and responsible mechanism for reforming insurance without skyrocketing consumers’ premiums, he has sprinted away from it during his campaign for the presidency.

Romney’s campaign health care plan is different from what he presented during Wednesday’s debate. Under his plan, Romney would transition Medicare from a defined-benefit program into a system of vouchers, block grant Medicaid to the states, and rely on demonstrably inefficient and ineffective policies such as high-risk pools and allowing consumers to purchase coverage across state lines to insure Americans.

Following the Supreme Court’s ruling to uphold the health care reform law under Congress’ taxing power, Republicans misconstrued its individual mandate as a “massive tax hike” on the middle class. This week, after the Congressional Budget Office upped its estimate on the number of Americans who are expected to face a penalty in 2016 for failing to purchase health insurance — increasing their original 4 million figure to 6 million — conservative outlets once again lamented the middle class families who will be “hit with a tax hike.”

But the revised 6 million figure does not mean the health care law puts a strain on the middle class. In fact, Obamacare will provide millions of families with large tax credits to help make health care more affordable for them, and the penalty will only be leveled against those Americans who choose not to purchase insurance even though they are able to afford it. The penalty from the individual mandate is projected to affect just 2 percent of the American population. The Center for American Progress shows how Obamacare represents a major tax cut for many families, even with the CBO’s new estimate:

The CBO pointed out that some of the increase in their revised figure reflects Republican governors’ opposition to expanding the Medicaid program in their states to provide more of their low-income residents with health coverage.

Opponents of President Obama’s health care reform law often justify their position by claiming Obamacare will hurt small businesses. But research on the subject in Massachusetts — where the health care reform that Mitt Romney enacted during his time as governor provides a test case for national health reform policy, thanks to its similarities to Obamacare — disproves this conservative talking point.

Economic researchers on a recent Georgetown University panel all agreed that Massachusetts’ small business owners were actually bolstered by health care reform, as the number of small businesses offering health care to their employees increased from 70 percent to 77 percent in the time since Romney enacted the reform in 2006. Linda Blumberg, an economist and senior fellow at the Urban Institute, said her organization’s research confirmed that small business owners are not struggling to afford the insurance plans that the health reform law requires them to provide for their employees:

“Our research demonstrated very clearly that there is no evidence that the reforms have had any negative impact on employment at all,” Blumberg said. Her organization studied specifically some industries that might feel a greater impact under the law—small employers or the retail and restaurant industries, which often don’t offer health insurance—and concluded the same. “In none of these sectors did we see reduced employment,” Blumberg said.

In fact, said Jack Connors Jr., a founding partner at Hill, Holliday, Connors, Cosmopulos, Inc., a Boston marketing firm, one of the largest in the United States, businesses could see a benefit when health insurance is “accepted as part of the compensation package for employees.”

“Many business leaders would say we have a competitive advantage,” Connors said.

Just like Obamacare, Romney’s health reform in Massachusetts is predicated on an individual mandate that requires employers to provide adequate health insurance coverage to their employees or risk paying a penalty. Although Republican lawmakers have decried Obamacare for strangling small business owners and middle-class workers, and have wasted about 89 hours and $51 million dollars in their attempts to repeal the law, the evidence from Romney’s home state suggests their efforts are doing little to protect small business interests.

Blumberg explained that her research on the economic effects of health care reform has left her confused about why Obamacare remains so politically contentious. “This was very much a compromise between liberal sensibilities and business sensibilities,” she explained. “So the entire perception of the federal law has been shocking to me, because this was really laid out as a moderate approach.”

The Affordable Care Act’s core framework — a requirement that all Americans can obtain insurance even if they have preexisting conditions, subsidies for Americans who cannot afford insurance, and a requirement that everyone buy into the insurance system rather than simply taking money out of it — was also the backbone of the health reform GOP presidential candidate Mitt Romney signed as governor of Massachusetts. Yet Romney long-abandoned his own health plan as a federal model in order to win votes in the GOP primary. He now says he will repeal the core Obamacare framework that he once supported.

Nevertheless, on Meet the Press this morning, Romney claimed that he would not eliminate some of the most popular aspects of the Affordable Care Act, such as protections for patients with pre-existing conditions and allowing young adults to stay on parents’ insurance plans:

“Of course there are a number of things that I like in health care reform that I’m going to put in place,” he said in an interview broadcast Sunday on NBC’s “Meet the Press.” “One is to make sure that those with pre-existing conditions can get coverage.” . . . .

“I say we’re going to replace Obamacare. And I’m replacing it with my own plan,” Romney said. “And even in Massachusetts when I was governor, our plan there deals with pre-existing conditions and with young people.”

Watch it:

Congressional Republicans have offered no plan forward aside from repeated votes to repeal Obamacare in its entirety. And Romney’s claim that he can retain Obamacare’s guarantee that all Americans have access to insurance while repealing its other parts is pure fantasy. The reason why both Romneycare and Obamacare contain a requirement that nearly everyone must buy health insurance is because “if patients can wait until they get sick to buy insurance, they will drain all the money out of an insurance plan that they have not previously paid into, leaving nothing left for the rest of the plan’s consumers.” Indeed, “seven states enacted a pre-existing conditions law without also passing an insurance coverage requirement, and all seven states saw health insurance premiums spiral out of control.”

Throughout his presidential campaign, Mitt Romney has been running away from the individual insurance mandate in the Affordable Care Act — even though a mandate is a cornerstone of the former Massachusetts governor’s health care reform law. “If I’m President of the United States, we’re gonna get rid of Obamacare and return, under our constitution, the 10th Amendment, the responsibility and care of health care to the people in the states,” Romney said during a GOP presidential debate.

But during his trip to Israel, Romney inadvertently praised the individual requirement and universal health care. “[F]or an American abroad, you can’t get much closer to the ideals and convictions of my own country than you do in Israel,” he said. And according to The New York Times, Romney spoke favorably about the fact that health care makes up a much smaller amount of Israel’s gross domestic product compared to the United States:

“Do you realize what health care spending is as a percentage of the G.D.P. in Israel? Eight percent,” he said. “You spend eight percent of G.D.P. on health care. You’re a pretty healthy nation. We spend 18 percent of our G.D.P. on health care, 10 percentage points more. That gap, that 10 percent cost, compare that with the size of our military — our military which is 4 percent, 4 percent. Our gap with Israel is 10 points of G.D.P. We have to find ways — not just to provide health care to more people, but to find ways to fund and manage our health care costs.”

Israel spends less on health care because of a universal health system that requires everyone to have insurance. Every Israeli citizen has the obligation to purchase health care services through one of the country’s four HMOs since government officials approved the National Health Insurance Law in 1995. People pay for 40 percent of their HMO’s costs through income-related contributions collected through the tax system, and the state pays the remaining 60 percent. And by many standards, Israelis are getting better health care than U.S. citizens. The infant mortality rate is much lower, and its mortality rate due to heart disease is half the U.S. rate.

Orly Manor, dean of the Hadassah-Hebrew University Braun School of Public Health, said U.S. officials could “learn a lot from the Israeli system. The quality is high, and the outcomes are good.” And it seems that, following his trip to Jerusalem, Romney would agree.