HLS 14RS-1537 ORIGINAL
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Regular Session, 2014
HOUSE BILL NO. 1090
BY REPRESENTATIVE HOLLIS
HEALTH CARE: Provides relative to the Interstate Health Care Compact
AN ACT1
To enact Part LXXV of Chapter 5 of Title 40 of the Louisiana Revised Statutes of 1950, to2
be comprised of R.S. 40:1300.381 through 1300.392, relative to the Interstate Health3
Care Compact; to enact the "Interstate Health Care Compact"; to provide for4
legislative findings; to provide necessary definitions; to require compact members5
take action to obtain congressional consent to the compact; to provide that the6
legislature is vested with the responsibility to regulate healthcare; to provide for7
healthcare funding; to establish the Interstate Advisory Health Care Commission; to8
provide for the commission's composition, powers, duties, and authority; to provide9
for an effective date of the compact; to provide for amending the compact; to provide10
for withdrawal from the compact; and to provide for related matters.11
Be it enacted by the Legislature of Louisiana:12
Section 1. Part LXXV of Chapter 5 of Title 40 of the Louisiana Revised Statutes of13
1950, comprised of R.S. 40:1300.381 through 1300.392, is hereby enacted to read as14
follows:15
PART LXXV. INTERSTATE HEALTH CARE COMPACT16
§1300.381. Short title17
This Part shall be known and cited as the "Interstate Health Care Compact".18
§1300.382. Legislative findings19
The Legislature of Louisiana hereby finds all of the following:20 HLS 14RS-1537 ORIGINAL
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(1) The separation of powers, both between the branches of the federal1
government and between federal and state governments, is essential to the2
preservation of individual liberty.3
(2) The United States Constitution creates a federal government of limited4
and enumerated powers and reserves to the states or to the people those powers not5
granted to the federal government.6
(3) The federal government has enacted many laws that have preempted state7
laws with respect to health care and placed increasing strain on state budgets,8
impairing other responsibilities such as education, infrastructure, and public safety.9
(4) The member states seek to protect individual liberty and personal control10
over healthcare decisions and believe the best method to achieve these ends is by11
vesting regulatory authority over health care with the 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 congressional consent may be more15
easily secured if the member states collectively seek consent through an interstate16
compact.17
§1300.383. Interstate Health Care Compact18
The Interstate Health Care Compact is hereby enacted into law and entered19
into by the state of Louisiana with any other states legally joining the compact in a20
form substantially similar to the form contained in this Part.21
§1300.384. Definitions22
As used in this Part:23
(1) "Commission" means the Interstate Advisory Health Care Commission.24
(2) "Effective date" means the date upon which this compact shall become25
effective for purposes of the operation of state and federal law in a member state,26
which shall be the later of either of the following:27
(a) The date upon which this compact shall be adopted under the laws of the28
member state.29 HLS 14RS-1537 ORIGINAL
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(b) The date upon which this compact receives the consent of the United1
States Congress pursuant to Article I, Section 10 of the United States Constitution,2
after it is adopted by at least two member states.3
(3) "Health care" means care, services, supplies, or plans related to the health4
of an individual and includes but is not limited to all of the following:5
(a) Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or6
palliative care and counseling, service, assessment, or procedure with respect to the7
physical or mental condition or functional status of an individual or that affects the8
structure or function of the body.9
(b) Sale or dispensing of a drug, device, equipment, or other item pursuant10
to a prescription.11
(c) An individual or group plan that provides, or pays the cost of care,12
services, or supplies related to the health of an individual, except any care, services,13
supplies, or plans provided by the United States Department of Defense and United14
States Department of Veteran Affairs or provided to Native Americans.15
(4) "Member state" means a state that is a signatory to this compact and has16
adopted it under the laws of that state.17
(5) "Member state base funding level" means a number equal to the total18
federal spending on health care in the member state during federal fiscal year 2010.19
On or before the effective date, each member state shall determine the member state20
base funding level for its state, and that number shall be binding upon that member21
state. The preliminary estimate of member state base funding level for the state of22
Louisiana is fifteen billion nine hundred fifty-seven million dollars.23
(6) "Member state current year funding level" means the member state base24
funding level multiplied by the member state current year population adjustment25
factor multiplied by the current year inflation adjustment factor.26
(7) "Member state current year population adjustment factor" means the27
average population of the member state in the current year less the average28
population of the member state in federal fiscal year 2010, divided by the average29 HLS 14RS-1537 ORIGINAL
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population of the member state in federal fiscal year 2010, plus one. Average1
population in a member state shall be determined by the United States Census2
Bureau.3
(8) "Current year inflation adjustment factor" means the total gross domestic4
product deflator in the current year divided by the total gross domestic product5
deflator in federal fiscal year 2010. The total gross domestic product deflator shall6
be determined by the Bureau of Economic Analysis of the United States Department7
of Commerce.8
§1300.385. State action; congressional consent; healthcare policy9
A. Member states shall take joint and separate action to secure congressional10
consent to this compact in order to return the authority to regulate health care to the11
member states consistent with the goals and principles articulated in this compact.12
B. Member states shall improve healthcare policy within their respective13
jurisdictions and according to the judgment and discretion of each member state.14
§1300.386. Legislature; regulation of health care15
The legislature of each member state has the primary responsibility to16
regulate health care in its state.17
§1300.387. State action; suspension of federal laws and rules18
A. Each member state, within its jurisdiction, may enact legislation to19
suspend the operation of all federal laws, rules, regulations, and orders regarding20
health care that are inconsistent with the laws, rules, regulations, and orders adopted21
by the member state pursuant to this compact.22
B.(1) Federal and state laws, rules, regulations, and orders regarding health23
care shall remain in effect unless a member state expressly suspends them pursuant24
to its authority under this compact.25
(2) For any federal law, rule, regulation, or order that remains in effect in a26
member state after the effective date, that member state shall be responsible for the27
associated funding obligations in its state.28 HLS 14RS-1537 ORIGINAL
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§1300.388. Healthcare funding1
A. Each federal fiscal year, each member state shall have the right to federal2
monies up to an amount equal to its member state current year funding level for that3
federal fiscal year, funded by congress as mandatory spending and not subject to4
annual appropriation, to support the exercise of member state authority under this5
compact. This funding shall not be conditional on any action of or regulation,6
policy, law, or rule being adopted by the member state.7
B. By the start of each federal fiscal year, congress shall establish an initial8
member state current year funding level for each member state, based upon9
reasonable estimates. The final member state current year funding level shall be10
calculated and funding shall be reconciled by congress based upon information11
provided by each member state and audited by the United States Government12
Accountability Office.13
§1300.389. Interstate Advisory Health Care Commission 14
A.(1) The Interstate Advisory Health Care Commission is established.15
(2) The commission consists of members appointed by each member state16
through a process to be determined by each member state. A member state may not17
appoint more than two members to the commission and may withdraw membership18
from the commission at any time.19
(3) Each commission member is entitled to one vote. The commission shall20
not act unless a majority of the members are present, and no action shall be binding21
unless approved by a majority of the commission's total membership.22
B.(1) The commission may elect from among its membership a chairman.23
(2) The commission may adopt and publish bylaws and policies that are not24
inconsistent with this compact.25
(3) The commission shall meet at least once a year and may meet more26
frequently.27
C. The commission may study issues of healthcare regulation that are of28
particular concern to the member states. The commission may make nonbinding29 HLS 14RS-1537 ORIGINAL
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recommendations to the member states. The legislatures of the member states may1
consider these recommendations in determining the appropriate healthcare policies2
in their respective states.3
D. The commission shall collect information and data to assist the member4
states in their regulation of health care, including assessing the performance of5
various state healthcare programs and compiling information on the prices of health6
care. The commission shall make this information and data available to the7
legislatures of the member states. Notwithstanding any other provision in this8
compact, no member state shall disclose to the commission the health information9
of any individual, nor shall the commission disclose the health information of any10
individual.11
E .(1) The commission shall be funded by the member states as agreed to by12
the member states.13
(2) The commission shall have the responsibilities and duties as may be14
conferred upon it by subsequent action of the respective legislatures of the member15
states in accordance with the terms of this compact.16
F. The commission shall not take any action within a member state that17
contravenes any state law of that member state.18
§1300.390. Effective date 19
A. This compact shall be effective on its adoption by at least two member20
states and congressional consent.21
B. This compact shall be effective unless the United States Congress, in22
consenting to it, alters its fundamental purposes, which are to do all of the following:23
(1) Secure the right of the member states to regulate health care in their24
respective states pursuant to this compact and to suspend the operation of any25
conflicting federal laws, rules, regulations, and orders within their states.26
(2) Secure federal funding for member states that choose to invoke their27
authority under this compact.28 HLS 14RS-1537 ORIGINAL
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§1300.391. Amendments to compact1
A. Member states, by unanimous agreement, may amend this compact from2
time to time without prior congressional consent or approval and any amendment3
shall be effective unless, within one year, congress disapproves that amendment. 4
B. Any state may join this compact after the date by adoption into law under5
its state constitution.6
§1300.392. Withdrawal from compact; dissolution7
A. A member state may withdraw from this compact by adopting a law to8
that effect, but no such withdrawal shall take effect until six months after the9
withdrawing member state has given notice of the withdrawal to the other member10
states.11
B. A withdrawing state shall be liable for any obligations that it may have12
incurred prior to the date on which its withdrawal becomes effective.13
C. This compact shall be dissolved upon the withdrawal of all but one of the14
member states.15
Section 2. This Act shall become effective upon signature by the governor or, if not16
signed by the governor, upon expiration of the time for bills to become law without signature17
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If18
vetoed by the governor and subsequently approved by the legislature, this Act shall become19
effective on the day following such approval.20
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Hollis HB No. 1090
Abstract: Provides for participation in the Interstate Health Care Compact.
Proposed law may be cited as the "Interstate Health Care Compact".
Proposed law provides for legislative findings.
Proposed law enacts the Interstate Health Care Compact and provides that the compact is
entered into by the state of La. with any other states legally joining the compact in a form
substantially similar to the form contained in proposed law. HLS 14RS-1537 ORIGINAL
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are additions.
Proposed law provides that the "effective date" upon which the compact shall become
effective for purposes of the operation of state and federal law in a member state, shall be
the later of either of the following:
(1)The date upon which the compact shall be adopted under the laws of the member
state.
(2)The date upon which the compact receives the consent of the U.S. Congress pursuant
to Art. I, §10 of the U.S. Constitution, after it is adopted by at least two member
states.
Proposed law defines "health care" as care, services, supplies, or plans related to the health
of an individual and includes but is not limited to all of the following:
(1)Preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care and
counseling, service, assessment, or procedure with respect to the physical or mental
condition or functional status of an individual or that affects the structure or function
of the body.
(2)Sale or dispensing of a drug, device, equipment, or other item pursuant to a
prescription.
(3)An individual or group plan that provides, or pays the cost of care, services, or
supplies related to the health of an individual, except any care, services, supplies, or
plans provided by the U.S. Dept. of Defense and U.S. Dept. of Veteran Affairs or
provided to Native Americans.
Proposed law defines "member state base funding level" as a number equal to the total
federal spending on health care in the member state during federal fiscal year 2010.
Proposed law requires, on or before the effective date, each member state to determine the
member state base funding level for its state, and that number shall be binding upon that
member state. Proposed law provides that the preliminary estimate of member state base
funding level for La. is $15,957,000,000.
Proposed law defines "member state current year funding level" as the member state base
funding level multiplied by the member state current year population adjustment factor
multiplied by the current year inflation adjustment factor.
Proposed law defines "member state current year population adjustment factor" as the
average population of the member state in the current year less the average population of the
member state in federal fiscal year 2010, divided by the average population of the member
state in federal fiscal year 2010, plus one. Proposed law provides that the average
population in a member state shall be determined by the U.S. Census Bureau.
Proposed law defines "current year inflation adjustment factor" as the total gross domestic
product deflator in the current year divided by the total gross domestic product deflator in
federal fiscal year 2010. Proposed law provides that the total gross domestic product
deflator shall be determined by the Bureau of Economic Analysis of the U.S. Dept. of
Commerce.
Proposed law requires member states to take joint and separate action to secure
congressional consent to the 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 the legislature of each member state has the primary responsibility
to regulate health care in their state and that member states shall improve healthcare policy
within their respective jurisdictions and according to the judgment and discretion of each
member state. HLS 14RS-1537 ORIGINAL
HB NO. 1090
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are additions.
Proposed law authorizes each member state, within its jurisdiction, to enact legislation to
suspend the operation of all federal laws, rules, regulations, and orders regarding health care
that are inconsistent with the laws, rules, regulations, and orders adopted by the member
state pursuant to the compact.
Proposed law requires federal and state laws, rules, regulations, and orders regarding health
care to remain in effect unless a member state expressly suspends them pursuant to its
authority under the compact. Proposed law further requires a member state, for any federal
law, rule, regulation, or order that remains in effect in a member state after the effective date
of the compact, to be responsible for the associated funding obligations in its state.
Proposed law authorizes each member state, each federal fiscal year, to 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 the compact.
Proposed law prohibits the funding from being conditional on any action of or regulation,
policy, law, or rule being adopted by the member state.
Proposed law requires congress, by the start of each federal fiscal year, to establish an initial
member state current year funding level for each member state, based upon reasonable
estimates. Proposed law further requires the final member state current year funding level
to be calculated, and funding to be reconciled by congress based upon information provided
by each member state and audited by the U.S. Government Accountability Office.
Proposed law establishes the Interstate Advisory Health Care Commission and provides for
the membership, voting, officers, and meetings of the commission.
Proposed law authorizes the commission to study issues of healthcare regulation that are of
particular concern to the member states and make nonbinding recommendations to the
member states.
Proposed law requires the commission to collect information and data to assist the member
states in their regulation of health care, including assessing the performance of various state
healthcare programs and compiling information on the prices of health care. Proposed law
further requires the commission to make the information and data available to the
legislatures of the member states.
Proposed law provides that the commission shall be funded by the member states as agreed
to by the member states and shall have the responsibilities and duties as may be conferred
upon it by subsequent action of the respective legislatures of the member states in
accordance with the terms of the compact. Proposed law prohibits the commission from
taking any action within a member state that contravenes any state law of that member state.
Proposed law provides that the compact shall be effective on its adoption by at least two
member states and congressional consent unless the U.S. Congress, in consenting to it, alters
its fundamental purposes, which are to do all of the following:
(1)Secure the right of the member states to regulate health care in their respective states
pursuant to the compact and to suspend the operation of any conflicting federal laws,
rules, regulations, and orders within their states.
(2)Secure federal funding for member states that choose to invoke their authority under
the compact.
Proposed law authorizes member states, by unanimous agreement, to amend the compact
from time to time without prior congressional consent or approval and provides that any
amendment shall be effective unless, within one year, congress disapproves that amendment. HLS 14RS-1537 ORIGINAL
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Proposed law provides that any state may join the compact after the date by adoption into
law under its state constitution.
Proposed law authorizes a member state to withdraw from the compact by adopting a law
to that effect, but no such withdrawal shall take effect until six months after the withdrawing
member state has given notice of the withdrawal to the other member states.
Proposed law provides that a withdrawing state shall be liable for any obligations that it may
have incurred prior to the date on which its withdrawal becomes effective.
Proposed law provides that the compact shall be dissolved upon the withdrawal of all but
one of the member states.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 40:1300.381-1300.392)