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S. B. No. 189 As IntroducedAs Introduced
|129th General Assembly|
To enact section 3702.01 of the Revised Code to join
the Health Care Compact.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 3702.01 of the Revised Code be
enacted to read as follows:
Sec. 3702.01. The "Health Care Compact" is hereby enacted
into law and entered into by this state as a party thereto with
any other state 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 United States 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
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 the
United States 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:
As used in this compact, unless the context clearly indicates
"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
(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;
(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
Except, "health care" does not include any care, services,
supplies, or plans provided by the United States department of
defense and the United States department of veterans affairs, or
provided to native Americans.
"Member state" means a state that is signatory to this
compact and that 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 Ohio is $35,043,000,000.
"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
"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
The member states shall take joint and separate action to
secure the consent of 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.
The legislatures of the member states have the primary
responsibility to regulate health care in their respective states.
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.
(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
(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 congress based upon information
provided by each member state and audited by the United States
government accountability office.
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 nonbinding 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.
This compact shall be effective upon its adoption by at least
two member states and consent of congress. This compact shall be
effective unless 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.
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.
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.