in Houston, Texas
Lt. Gov. David Dewhurst, Sen. Jane Nelson back compacts bill as part of state health care reform package
Friday, Jun 10, 2011, 12:59PM CST
By Mark Lisheron
Capitol dome

Lt. Gov. David Dewhurst and Sen. Jane Nelson support the addition of a bill challenging the national health care overhaul to a state health care reform package, staff members for both offices say.

Senate Bill 5, drafted by Rep. Lois Kolkhorst, R-Brenham, and now being carried by Sen. Joan Huffman, R-Houston, would allow Texas to join with other states to form their own health care compacts.

The ability to enter into compacts without federal interference is guaranteed in Section 10 of Article 1 of the U.S. Constitution. States have entered into hundreds of compacts, nearly all of them involving some form of commerce.

Never has it been used to challenge the authority of the federal government to define the terms of a federal and state partnership program, as SB 5 does with Medicaid. So far, Georgia and Oklahoma are the only states to approve health care compacts, although legislation has over the past year been introduced in another dozen states.

The compacts bill for now joins a trio of state health reforms now called Senate Bill 7, by Nelson. The bill calls for cost cutting and efficiency mandates for the state Department of Health and Human Services.

The bill also calls for widespread revisions of the state health care system the Legislative Budget Board estimates could save Texas taxpayers $467 million over several years. The bill would create the Texas Institute of Health Care Quality and Efficiency to oversee cost control and the quality and accountability of health care in Texas.

The state would allow for health care collaboratives between doctors and health care providers and undertake a fundamental reform of the health care payment system in the state.

Dewhurst and Nelson, the chairman of the Senate’s Health and Human Services Committee, have championed these state-driven reforms for the past two sessions. In both cases, the packages failed to come to a vote before the regular sessions ended.

The health care compacts bill met the same fate, although Kolkhorst has had to work harder to keep it alive. This is the second time Kolkhorst has convinced House members to attach her bill to the bigger reform package.

Kolkhorst on Wednesday told Texas Watchdog she wondered how deeply committed her fellow conservative Republicans were to the concept of state compacts as a health care reform tool.

Two of those conservatives in the Senate, Dewhurst and Nelson, reaffirmed their support late Thursday. Huffman and Nelson are listed as the Senate authors of the Kolkhorst bill.

Dewhurst and Nelson also expressed confidence that this enhanced reservoir of reform will pass in the Senate. But while a huge Republican majority in the House has carried all of the bills along, Senate rules have stopped them in two regular sessions.

Much will depend on how the combined reform bill is perceived by Senate Democrats as an assault on the Patient Protection and Affordable Care Act, considered a signature piece of legislation by a Democratic president.

For decades the Senate observed a rule not binding by law that legislation would not come to the floor unless two-thirds of the senators agreed that it should. Nineteen Senate Republicans set aside the rule over the objections of the 12 Democratic senators to get a budget passed in early May.

Should the Democrats hold fast as a bloc in opposition to SB 7 or should the Republican majority suspend its two-thirds rule to bring it to a vote remains to be seen.
Contact Mark Lisheron at 512-299-2318 or or on Twitter at @marktxwatchdog.

Follow Texas Health Care Report on Twitter, and fan us on Facebook. Texas Health Care Report is a project of Texas Watchdog.

Photo of Texas state Capitol dome by flickr user dziner, used via a Creative Commons license.
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