82S10032 PMO-F
  By: Kolkhorst H.B. No. 5
  relating to the Interstate Health Care Compact.
         SECTION 1.  Title 15, Insurance Code, is amended by adding
  Chapter 5002 to read as follows:
         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
  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
  (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
  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 on the 91st day after the last day of the
  legislative session.