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S.B. 208





Chief Sponsor: J. Stuart Adams

House Sponsor: Bradley M. Daw

             7      LONG TITLE
             8      General Description:
             9          This bill enacts a Health Care Compact.
             10      Highlighted Provisions:
             11          This bill:
             12          .    adopts the Health Care Compact;
             13          .    defines terms;
             14          .    joins an interstate Advisory Health Care Commission; and
             15          .    pledges to take joint and separate action to secure the consent of the United States
             16      Congress to the compact in order to return the authority to regulate health care to the
             17      member states, consistent with the goals and principles articulated in the compact.
             18      Money Appropriated in this Bill:
             19          None
             20      Other Special Clauses:
             21          None
             22      Utah Code Sections Affected:
             23      ENACTS:
             24          63M-1-2507, Utah Code Annotated 1953
             26      Be it enacted by the Legislature of the state of Utah:
             27          Section 1. Section 63M-1-2507 is enacted to read:

             28          63M-1-2507. The Health Care Compact.
             29          The Health Care Compact is hereby enacted and entered into with all other jurisdictions
             30      that legally join in the compact, which is, in form, substantially as follows:
Health Care Compact

             32          Whereas, the separation of powers, both between the branches of the federal
             33      government and between federal and state authority, is essential to the preservation of
             34      individual liberty;
             35          Whereas, the Constitution creates a federal government of limited and numerated
             36      powers, and reserves to the states or to the people those powers not granted to the federal
             37      government;
             38          Whereas, the federal government has enacted many laws that have preempted state laws
             39      with respect to health care, and placed increasing strain on state budgets, impairing other
             40      responsibilities such as education, infrastructure, and public safety;
             41          Whereas, the member states seek to protect individual liberty and personal control over
             42      health care decisions, and believe the best method to achieve these ends is by vesting
             43      regulatory authority over health care in the states;
             44          Whereas, by acting in concert, the member states may express and inspire confidence in
             45      the ability of each member state to govern health care effectively; and
             46          Whereas, the member states recognize that consent of Congress may be more easily
             47      secured if the member states collectively seek consent through an interstate compact;
             48          NOW THEREFORE, the member states hereto resolve, and by the adoption into law
             49      under their respective state constitutions of this health care compact, agree, as follows:
             50           Sec. 1. Definitions.
             51          As used in this compact, unless the context clearly indicates otherwise:
             52          (1) "Commission" means the Interstate Advisory Health Care Commission.
             53          (2) "Effective date" means the date upon which this compact shall become effective for
             54      purposes of the operation of state and federal law in a member state, which shall be the later of:
             55          (a) the date upon which this compact shall be adopted under the laws of the member
             56      state, and
             57          (b) the date upon which this compact receives the consent of Congress pursuant to
             58      Article I, Section 10, of the United States Constitution, after at least two member states adopt

             59      this compact.
             60          (3) "Health care" means care, services, supplies, or plans related to the health of an
             61      individual and includes but is not limited to:
             62          (a) preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care
             63      and counseling, service, assessment, or procedure with respect to the physical or mental
             64      condition or functional status of an individual or that affects the structure or function of the
             65      body, and
             66          (b) sale or dispensing of a drug, device, equipment, or other item in accordance with a
             67      prescription, and
             68          (c) an individual or group plan that provides, or pays the cost of, care, services, or
             69      supplies related to the health of an individual, except any care, services, supplies, or plans
             70      provided by the United States Department of Defense and United States Department of Veteran
             71      Affairs, or provided to Native Americans.
             72          (4) "Member state" means a state that is signatory to this compact and has adopted it
             73      under the laws of that state.
             74          (5) "Member state base funding level" means a number equal to the total federal
             75      spending on health care in the member state during federal fiscal year 2010. On or before the
             76      effective date, each member state shall determine the member state base funding level for its
             77      state, and that number shall be binding upon that member state. The preliminary estimate of
             78      member state base funding level for the state of Utah is $4,102,000,000.
             79          (6) "Member state current year funding level" means the member state base funding
             80      level multiplied by the member state current year population adjustment factor multiplied by
             81      the current year inflation adjustment factor.
             82          (7) "Member state current year population adjustment factor" means the average
             83      population of the member state in the current year less the average population of the member
             84      state in federal fiscal year 2010, divided by the average population of the member state in
             85      federal fiscal year 2010, plus 1. Average population in a member state shall be determined by
             86      the United States Census Bureau.
             87          (8) "Current year inflation adjustment factor" means the total gross domestic product
             88      deflator in the current year divided by the total gross domestic product deflator in federal fiscal
             89      year 2010. Total gross domestic product deflator shall be determined by the Bureau of

             90      Economic Analysis of the United States Department of Commerce.
             91           Sec. 2. Pledge.
             92          The member states shall take joint and separate action to secure the consent of the
             93      United States Congress to this compact in order to return the authority to regulate health care to
             94      the member states consistent with the goals and principles articulated in this compact. The
             95      member states shall improve health care policy within their respective jurisdictions and
             96      according to the judgment and discretion of each member state.
             97           Sec. 3. Legislative Power.
             98          The legislatures of the member states have the primary responsibility to regulate health
             99      care in their respective states.
             100           Sec. 4. State Control.
             101          Each member state, within its state, may suspend by legislation the operation of all
             102      federal laws, rules, regulations, and orders regarding health care that are inconsistent with the
             103      laws and regulations adopted by the member state pursuant to this compact. Federal and state
             104      laws, rules, regulations, and orders regarding health care will remain in effect unless a member
             105      state expressly suspends them pursuant to its authority under this compact. For any federal
             106      law, rule, regulation, or order that remains in effect in a member state after the effective date,
             107      that member state shall be responsible for the associated funding obligations in its state.
             108           Sec. 5. Funding.
             109          (a) Each federal fiscal year, each member state shall have the right to federal monies up
             110      to an amount equal to its member state current year funding level for that federal fiscal year,
             111      funded by Congress as mandatory spending and not subject to annual appropriation, to support
             112      the exercise of member state authority under this compact. This funding shall not be
             113      conditional on any action of or regulation, policy, law, or rule being adopted by the member
             114      state.
             115          (b) By the start of each federal fiscal year, Congress shall establish an initial member
             116      state current year funding level for each member state, based upon reasonable estimates. The
             117      final member state current year funding level shall be calculated, and funding shall be
             118      reconciled by the United States Congress based upon information provided by each member
             119      state and audited by the United States Government Accountability Office.
             120           Sec. 6. Interstate Advisory Health Care Commission.

             121          (a) The Interstate Advisory Health Care Commission is established. The commission
             122      consists of members appointed by each member state through a process to be determined by
             123      each member state. A member state may not appoint more than two members to the
             124      commission and may withdraw membership from the commission at any time. Each
             125      commission member is entitled to one vote. The commission shall not act unless a majority of
             126      the members are present, and no action shall be binding unless approved by a majority of the
             127      commission's total membership.
             128          (b) The commission may elect from among its membership a chairperson. The
             129      commission may adopt and publish bylaws and policies that are not inconsistent with this
             130      compact. The commission shall meet at least once a year, and may meet more frequently.
             131          (c) The commission may study issues of health care regulation that are of particular
             132      concern to the member states. The commission may make non-binding recommendations to
             133      the member states. The legislatures of the member states may consider these recommendations
             134      in determining the appropriate health care policies in their respective states.
             135          (d) The commission shall collect information and data to assist the member states in
             136      their regulation of health care, including assessing the performance of various state health care
             137      programs and compiling information on the prices of health care. The commission shall make
             138      this information and data available to the legislatures of the member states. Notwithstanding
             139      any other provision in this compact, no member state shall disclose to the commission the
             140      health information of any individual, nor shall the commission disclose the health information
             141      of any individual.
             142          (e) The commission shall be funded by the member states as agreed to by the member
             143      states. The commission shall have the responsibilities and duties as may be conferred upon it
             144      by subsequent action of the respective legislatures of the member states in accordance with the
             145      terms of this compact.
             146          (f) The commission shall not take any action within a member state that contravenes
             147      any state law of that member state.
             148           Sec. 7. Congressional Consent.
             149          This compact shall be effective on its adoption by at least two member states and
             150      consent of the United States Congress. This compact shall be effective unless the United States
             151      Congress, in consenting to this compact, alters the fundamental purposes of this compact,

             152      which are:
             153          (a) to secure the right of the member states to regulate health care in their respective
             154      states pursuant to this compact and to suspend the operation of any conflicting federal laws,
             155      rules, regulations, and orders within their states; and
             156          (b) to secure federal funding for member states that choose to invoke their authority
             157      under this compact, as prescribed by Section 5 of this compact.
             158           Sec. 8. Amendments.
             159          The member states, by unanimous agreement, may amend this compact from time to
             160      time without the prior consent or approval of Congress and any amendment shall be effective
             161      unless, within one year, the Congress disapproves that amendment. Any state may join this
             162      compact after the date on which Congress consents to the compact by adoption into law under
             163      its state constitution.
             164           Sec. 9. Withdrawal; Dissolution.
             165          Any member state may withdraw from this compact by adopting a law to that effect, but
             166      no such withdrawal shall take effect until six months after the governor of the withdrawing
             167      member state has given notice of the withdrawal to the other member states. A withdrawing
             168      state shall be liable for any obligations that it may have incurred prior to the date on which its
             169      withdrawal becomes effective. This compact shall be dissolved upon the withdrawal of all but
             170      one of the member states.

Legislative Review Note
    as of 2-7-12 8:42 AM

Office of Legislative Research and General Counsel

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