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Regular Session, 2011
SENATE BILL NO. 206
BY SENATOR GUILLORY
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INTERGOVERN RELATI ONS. Provides for the Health Care Compact. (See Act)
AN ACT1
To enact Part LXX of Chapter 5 of Title 40 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 40:1300.331 through 1300.340, relative to the Health Care3
Compact; to provide for definitions; to provide for the regulation of health care by4
the state; to provide for powers of the state; to provide for the Interstate Advisory5
Health Care Commission; to provide for congressional consent; to provide for the6
methods of amendment of the compact; to provide for withdrawal from the compact;7
and to provide for related matters.8
Be it enacted by the Legislature of Louisiana:9
Section 1. Part LXX of Chapter 5 of Title 40 of the Louisiana Revised Statutes of10
1950, comprised of R.S. 40:1300.331 through 1300.340, is hereby enacted to read as11
follows:12
PART LX. HEALTH CARE COMPACT13
§1300.331. Legislative Intent14
The Legislature of Louisiana hereby finds the following:15
(1)The separation of powers, both between the branches of the federal16
government and between federal and state authority, is essential to the17 SB NO. 206
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preservation of individual liberty.1
(2)The Constitution of the United States of America creates a federal2
government of limited and enumerated powers and reserves to the states or to3
the people those powers not granted to the federal government.4
(3)The federal government has enacted many laws that have preempted5
state laws with respect to health care and placed increasing strain on state6
budgets, impairing other responsibilities such as education, infrastructure, and7
public safety.8
(4)The member states of this compact seek to protect individual liberty9
and personal control over health care decisions and believe the best method to10
achieve these ends is by vesting regulatory authority over health care in the11
states.12
(5)By acting in concert, the member states may express and inspire13
confidence in the ability of each member state to govern health care effectively.14
(6)The member states recognize that consent of Congress may be more15
easily secured if the member states collectively seek consent through an16
interstate compact.17
§1300.332. Definitions18
As used in this Part, the following terms shall have the following19
meanings:20
(1) "Commission" means the Interstate Advisory Health Commission.21
(2) "Health care" means care, services, supplies, or plans related to the22
health of an individual and includes but is not limited to:23
(a) Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or24
palliative care and counseling, service, assessment, or procedure with respect25
to the physical or mental condition or functional status of an individual or that26
affects the structure or function of the body.27
(b) The sale or dispensing of a drug, device, equipment, or other item in28
accordance with a prescription.29 SB NO. 206
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(c) An individual or group plan that provides, or pays the cost of, care,1
services, or supplies related to the health of an individual, except any care,2
services, supplies, or plans provided by the United States Department of Defense3
and United States Department of Veterans Affairs, or provided to Native4
Americans.5
(3) "Member state" means a state that is signatory to this compact and6
has adopted it under the laws of that state.7
(4) "Member state base funding level" means a number equal to the total8
federal spending on health care in the member state during federal fiscal year9
2010. On or before the effective date, each member state shall determine the10
member state base funding level for its state, and that number shall be binding11
upon that member state.12
(5) "Member state current year funding level" means the member state13
base funding level multiplied by the member state current year population14
adjustment factor multiplied by the current year inflation adjustment factor.15
(6) "Member state current year population adjustment factor" means16
the average population of the member state in the current year less the average17
population of the member state in federal fiscal year 2010, divided by the18
average population of the member state in federal fiscal year 2010, plus one.19
Average population in a member state shall be determined by the United States20
Census Bureau.21
(7) "Current year inflation adjustment factor" means the total gross22
domestic product deflator in the current year divided by the total gross23
domestic product deflator in federal fiscal year 2010. Total gross domestic24
product deflator shall be determined by the Bureau of Economic Analysis of the25
United States Department of Commerce.26
§1300.333. Pledge27
The member states shall take joint and separate action to secure the28
consent of the United States Congress to this compact in order to return the29 SB NO. 206
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authority to regulate health care to the member states consistent with the goals1
and principles articulated in this compact. The member states shall improve2
health care policy within their respective jurisdictions and according to the3
judgment and discretion of each member state.4
§1300.334. Legislative power5
The legislatures of the member states have the primary responsibility to6
regulate health care in their respective states.7
§1300.335. State control8
Each member state, within its state, may suspend by legislation the9
operation of all federal laws, rules, regulations, and orders regarding health10
care that are inconsistent with the laws and regulations adopted by the member11
state pursuant to this compact. Federal and state laws, rules, regulations, and12
orders regarding health care will remain in effect unless a member state13
expressly suspends them pursuant to its authority under this compact. For any14
federal law, rule, regulation, or order that remains in effect in a member state,15
that member state shall be responsible for the associated funding obligations in16
its state.17
§1300.336. Funding18
A. Each federal fiscal year, each member state shall have the right to19
federal monies up to an amount equal to its member state current year funding20
level for that federal fiscal year, funded by Congress as mandatory spending21
and not subject to annual appropriation, to support the exercise of member22
state authority under this compact. This funding shall not be conditional on any23
action of or regulation, policy, law, or rule being adopted by the member state.24
B. By the start of each federal fiscal year, Congress shall establish an25
initial member state current year funding level for each member state, based26
upon reasonable estimates. The final member state current year funding level27
shall be calculated, and funding shall be reconciled by the United States28
Congress based upon information provided by each member state and audited29 SB NO. 206
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by the United States Government Accountability Office.1
§1300.337. Interstate advisory health care commission2
A. The Interstate Advisory Health Care Commission is hereby3
established. The commission shall consist of members appointed by each4
member state through a process to be determined by each member state. A5
member state may not appoint more than two members to the commission and6
may withdraw membership from the commission at any time. Each commission7
member is entitled to one vote. The commission shall not act unless a majority8
of the members are present, and no action shall be binding unless approved by9
a majority of the commission's total membership.10
B. The commission may elect from among its membership a chairperson.11
The commission may adopt and publish bylaws and policies that are not12
inconsistent with this compact. The commission shall meet at least once a year,13
and may meet more frequently.14
C. The commission may study issues of health care regulation that are15
of particular concern to the member states. The commission may make non-16
binding recommendations to the member states. The legislatures of the member17
states may consider these recommendations in determining the appropriate18
health care policies in their respective states.19
D. The commission shall collect information and data to assist the20
member states in their regulation of health care, including assessing the21
performance of various state health care programs and compiling information22
on the prices of health care. The commission shall make this information and23
data available to the legislatures of the member states. Notwithstanding any24
other provision in this compact, no member state shall disclose to the25
commission the health information of any individual, nor shall the commission26
disclose the health information of any individual.27
E. The commission shall be funded by the member states as agreed to by28
the member states. The commission shall have the responsibilities and duties as29 SB NO. 206
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may be conferred upon it by subsequent action of the respective legislatures of1
the member states in accordance with the terms of this compact.2
F. The commission shall not take any action within a member state that3
contravenes any state law of that member state.4
§1300.338. Congressional consent5
This compact shall be effective on its adoption by at least two member6
states and consent of the United States Congress. This compact shall be effective7
unless the United States Congress, in consenting to this compact, alters the8
fundamental purposes of this compact, which are:9
(1) To secure the right of the member states to regulate health care in10
their respective states pursuant to this compact and to suspend the operation of11
any conflicting federal laws, rules, regulations, and orders within their states.12
(2) To secure federal funding for member states that choose to invoke13
their authority under this compact.14
§1300.339. Amendments15
The member states, by unanimous agreement, may amend this compact16
from time to time without the prior consent or approval of Congress and any17
amendment shall be effective unless, within one year, the Congress disapproves18
that amendment. Any state may join this compact after the date on which19
Congress consents to the compact by adoption into law under its state20
constitution.21
§1300.340. Withdrawal; dissolution22
Any member state may withdraw from this compact by adopting a law23
to that effect, but no such withdrawal shall take effect until six months after the24
governor of the withdrawing member state has given notice of the withdrawal25
to the other member states. A withdrawing state shall be liable for any26
obligations that it may have incurred prior to the date on which its withdrawal27
becomes effective. This compact shall be dissolved upon the withdrawal of all28
but one of the member states.29 SB NO. 206
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Section 2. The provisions of this Act shall become effective upon the later of:1
(1) The date upon which this compact shall be enacted by the state of2
Louisiana.3
(2) The date upon which this compact receives the consent of Congress4
pursuant to Article I, Section 10, of the United States Constitution, after at least5
two states adopt and enact this compact.6
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Greg Waddell.
DIGEST
Proposed law provides for the Health Care Compact.
Proposed law provides that the member states shall take joint and separate action to secure
the consent of the United States Congress to this compact in order to return the authority to
regulate health care to the member states consistent with the goals and principles articulated
in the compact.
Proposed law provides that the legislatures of the member states have the primary
responsibility to regulate health care in their respective states.
Proposed law provides that each member state, within its state, may suspend by legislation
the operation of all federal laws, rules, regulations, and orders regarding health care that are
inconsistent with the laws and regulations adopted by the member state pursuant to the
compact.
Proposed law provides that federal and state laws, rules, regulations, and orders regarding
health care will remain in effect unless a member state expressly suspends them pursuant to
its authority under this compact. For any federal law, rule, regulation, or order that remains
in effect in a member state, that member state shall be responsible for the associated funding
obligations in its state.
Proposed law provides that each federal fiscal year, each member state shall have the right
to federal monies up to an amount equal to its member state current year funding level for
that federal fiscal year, funded by Congress as mandatory spending and not subject to annual
appropriation, to support the exercise of member state authority under this compact. This
funding shall not be conditional on any action of or regulation, policy, law, or rule being
adopted by the member state.
Proposed law provides that by the start of each federal fiscal year, Congress shall establish
an initial member state current year funding level for each member state, based upon
reasonable estimates. The final member state current year funding level shall be calculated,
and funding shall be reconciled by the United States Congress based upon information
provided by each member state and audited by the United States Government Accountability
Office.
Proposed law provides for the establishment of The Interstate Advisory Health Care
Commission. Proposed law further provides that the commission consists of members
appointed by each member state through a process to be determined by each member state.
A member state may not appoint more than two members to the commission and may
withdraw membership from the commission at any time. Each commission member is SB NO. 206
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entitled to one vote. The commission shall not act unless a majority of the members are
present, and no action shall be binding unless approved by a majority of the commission's
total membership.
Proposed law provides that the commission may study issues of health care regulation that
are of particular concern to the member states and may make non-binding recommendations
to the member states.
Proposed law provides that the commission shall collect information and data to assist the
member states in their regulation of health care, including assessing the performance of
various state health care programs and compiling information on the prices of health care.
The commission shall make this information and data available to the legislatures of the
member states.
Proposed law provides that the compact shall be effective on its adoption by at least two
member states and consent of the United States Congress. This compact shall be effective
unless the United States Congress, in consenting to this compact, alters the fundamental
purposes of this compact, which are provided for in proposed law.
Proposed law provides that the member states, by unanimous agreement, may amend this
compact from time to time without the prior consent or approval of congress and any
amendment shall be effective unless, within one year, the congress disapproves that
amendment. Any state may join this compact after the date on which congress consents to
the compact by adoption into law under its state constitution.
Proposed law provides that any member state may withdraw from this compact by adopting
a law to that effect, but no such withdrawal shall take effect until six months after the
governor of the withdrawing member state has given notice of the withdrawal to the other
member states. A withdrawing state shall be liable for any obligations that it may have
incurred prior to the date on which its withdrawal becomes effective. This compact shall be
dissolved upon the withdrawal of all but one of the member states.
Effectiveness contingent upon passage of proposed law and congressional approval.
(Adds R.S. 40:1300.331 - 1300.340)