Missouri voters participated last week in what, pols and pundits informed us, was a referendum on healthcare reform.

But it’s a bit more complicated than that.

The referendum focused on a specific problem with the healthcare reform legislation that was enacted earlier this year by congressional Democrats and the Obama administration—a problem that troubles not just conservatives but many progressives.

So the Missouri vote was not a rejection of healthcare reform in general.

To be sure, many of the Missouri voters would have been delighted to do that. The majority of voters who cast ballots in the state’s August 3 election were Republicans, as Missouri’s most hotly contested congressional primaries on that day were for GOP nominations. As the Republican base has tended to be more vehement in its opposition to reform, it serves to reason that no matter how the referendum was worded, there would have been plenty of opposition to what is derisively referred to as “Obamacare.”

However, the question on the ballot did not have to do with healthcare reform in general, or even with the broad particulars of the Obama plan.

Rather, it dealt with a precise complaint:

The healthcare legislation passed by Congress and signed by Obama includes a pair of mandates: one that requires businesses to provide health-insurance coverage to employees and another that requires individuals and families that are not covered to buy insurance from private firms.

Asked whether they supported a ballot initiative that sought to exempt the state’s residents from the mandate, the overwhelming majority of Missourians voted “yes.”

That comes as no surprise. Polls by the Kaiser Family Foundation have consistently found that the individual mandate is the least popular piece of the new law.

But just because people oppose mandates does not mean that they oppose reform. In fact, the Kaiser polling has found that many aspects of the current law have solid popular support—including moves to expand access, such as the creation of insurance exchanges and strict regulations of insurance companies regarding the dumping of patients with pre-existing conditions.

Activists I have talked on the ground in Missouri—some of them strong supporters of reform—told me they had a hard time getting excited about defending the mandates.

And rightly so.

Healthcare is a right, not a burden.

Americans should have access to healthcare when they need it, and the quality and affordability of that care should be guaranteed under a single-payer “Medicare for All” system.

Instead, under the federal healthcare plan that was passed earlier this year, healthcare becomes a burden—something that citizens must pay for even when they are not sick. Worse yet, the money they pay goes to the same insurance companies that have jacked up prices while maintaining a system that seeks to deny rather than provide care.

The mandates—at least as they are structured in the currect law—were always a problem.

Candidate Barack Obama went out of his way to criticize them when he was seeking the Democratic nomination for president in 2008.

Missouri voters have taken the same position as candidate Obama.

Now, the question is whether Obama and Democrats in Congress will get the right message: that American wants real reform of the healthcare system, not mandates that force them to write more checks to insurance corporations.