SB 473 - This act modifies what is commonly known as the Health Care Freedom Act which was approved by the Missouri voters in 2010. The act restates Missouri's public policy of allowing its citizens the freedom to choose or decline to choose any mode of securing health care services without facing a penalty. The act also posits several findings of fact of how the Patient Protection and Affordable Care Act and implementing a state-based exchange would subject Missouri citizens and employers to penalties. The act provides that it is against Missouri public policy to implement or operate a health insurance exchange in Missouri. The act further provides that if a health insurance issuer operating in Missouri accepts any remuneration that may result in the imposition of penalties contrary to Missouri's public policy, then the director of insurance shall suspend the issuer's license to transact business in Missouri. The suspension will stay in place until the issuer represents that it has returned the remuneration to its source and will decline any such future remuneration. The act imposes a duty upon the attorney general to seek injunctive relief and other appropriate remedies whenever the public policy set forth in the act is being violated.STEPHEN WITTE