82R11375 PMO-D
	By: Nelson, Huffman	S.B. No. 25

	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. The
	preliminary estimate of Member State Base Funding Level for the
	State of Texas is Sixty Billion, Four Hundred and Thirty-Four
	Million Dollars ($60,434,000,000).
	"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.