By: Huffman, Nelson S.B. No. 5
A BILL TO BE ENTITLED
AN ACT
relating to the Interstate Health Care Compact.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Title 15, Insurance Code, is amended by adding
Chapter 5002 to read as follows:
CHAPTER 5002. INTERSTATE HEALTH CARE COMPACT
Sec. 5002.001. EXECUTION OF COMPACT. This state enacts the
Interstate Health Care Compact and enters into the compact with all
other states legally joining in the compact in substantially the
following form:
Whereas, the separation of powers, both between the branches of the
Federal government and between Federal and State authority, is
essential to the preservation of individual liberty;
Whereas, the Constitution creates a Federal government of limited
and enumerated powers, and reserves to the States or to the people
those powers not granted to the Federal government;
Whereas, the Federal government has enacted many laws that have
preempted State laws with respect to Health Care, and placed
increasing strain on State budgets, impairing other
responsibilities such as education, infrastructure, and public
safety;
Whereas, the Member States seek to protect individual liberty and
personal control over Health Care decisions, and believe the best
method to achieve these ends is by vesting regulatory authority
over Health Care in the States;
Whereas, by acting in concert, the Member States may express and
inspire confidence in the ability of each Member State to govern
Health Care effectively; and
Whereas, the Member States recognize that consent of Congress may
be more easily secured if the Member States collectively seek
consent through an interstate compact;
NOW THEREFORE, the Member States hereto resolve, and by the
adoption into law under their respective State Constitutions of
this Health Care Compact, agree, as follows:
Sec. 1. Definitions. As used in this Compact, unless the context
clearly indicates otherwise:
"Commission" means the Interstate Advisory Health Care Commission.
"Effective Date" means the date upon which this Compact shall
become effective for purposes of the operation of State and Federal
law in a Member State, which shall be the later of:
a) the date upon which this Compact shall be adopted
under the laws of the Member State, and
b) the date upon which this Compact receives the
consent of Congress pursuant to Article I, Section 10,
of the United States Constitution, after at least two
Member States adopt this Compact.
"Health Care" means care, services, supplies, or plans related to
the health of an individual and includes but is not limited to:
(a) 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, and
(b) sale or dispensing of a drug, device, equipment, or other item
in accordance with a prescription, and
(c) 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
United States Department of Defense and United States Department of
Veteran Affairs, or provided to Native Americans.
"Member State" means a State that is signatory to this Compact and
has adopted it under the laws of that State.
"Member State Base Funding Level" means a number equal to the total
Federal spending on Health Care in the Member State during Federal
fiscal year 2010. On or before the Effective Date, each Member State
shall determine the Member State Base Funding Level for its State,
and that number shall be binding upon that Member State.
"Member State Current Year Funding Level" means the Member State
Base Funding Level multiplied by the Member State Current Year
Population Adjustment Factor multiplied by the Current Year
Inflation Adjustment Factor.
"Member State Current Year Population Adjustment Factor" means 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 1. Average population in a Member State shall
be determined by the United States Census Bureau.
"Current Year Inflation Adjustment Factor" means the Total Gross
Domestic Product Deflator in the current year divided by the Total
Gross Domestic Product Deflator in Federal fiscal year 2010. Total
Gross Domestic Product Deflator shall be determined by the Bureau
of Economic Analysis of the United States Department of Commerce.
Sec. 2. Pledge. 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 this Compact. The Member States shall improve Health
Care policy within their respective jurisdictions and according to
the judgment and discretion of each Member State.
Sec. 3. Legislative Power. The legislatures of the Member States
have the primary responsibility to regulate Health Care in their
respective States.
Sec. 4. State Control. 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 this Compact. 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 after the Effective Date, that
Member State shall be responsible for the associated funding
obligations in its State.
Sec. 5. Funding.
(a) 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.
(b) 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.
Sec. 6. Interstate Advisory Health Care Commission.
(a) The Interstate Advisory Health Care Commission is
established. 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 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.
(b) The Commission may elect from among its membership a
Chairperson. The Commission may adopt and publish bylaws and
policies that are not inconsistent with this Compact. The
Commission shall meet at least once a year, and may meet more
frequently.
(c) The Commission may study issues of Health Care regulation that
are of particular concern to the Member States. The Commission may
make non-binding recommendations to the Member States. The
legislatures of the Member States may consider these
recommendations in determining the appropriate Health Care
policies in their respective States.
(d) 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. Notwithstanding any other provision in this
Compact, no Member State shall disclose to the Commission the
health information of any individual, nor shall the Commission
disclose the health information of any individual.
(e) The Commission shall be funded by the Member States as agreed
to by the Member States. The Commission 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 this Compact.
(f) The Commission shall not take any action within a Member State
that contravenes any State law of that Member State.
Sec. 7. Congressional Consent. This 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:
(a) To secure the right of the Member States to regulate Health
Care in their respective States pursuant to this Compact and to
suspend the operation of any conflicting federal laws, rules,
regulations, and orders within their States; and
(b) To secure Federal funding for Member States that choose to
invoke their authority under this Compact, as prescribed by Section
5 above.
Sec. 8. Amendments. 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.
Sec. 9. Withdrawal; Dissolution. 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.
SECTION 2. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2011.
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