The compact, which would challenge the authority of the federal government to dictate the terms of the federally and state funded Medicaid program, was part of a wide-ranging health care reform bill, Senate Bill 7, passed by the Texas Legislature in its recently concluded special session.
Georgia, Oklahoma and Missouri have already signed onto the compacts movement, with Missouri Gov. Jay Nixon signing a bill into law on Thursday.
The law establishes Texas, along with the other three states, as pioneers in an uncharted use of Article 1, Section 10 of the Constitution which allows states to enter into agreements that, with the approval of Congress, cannot be abridged by the federal government. There are more than 200 state compacts currently in effect, nearly all of them related to commerce.
Article 1, however, does not outline the terms by which Congress might be compelled to agree to a state health care compact. Supporters are hoping to tip the balance in their favor as more states pass compacts laws.
Perry said the compacts language is an important part of a health care reform package the Legislative Budget Board has estimated will save Texas $467 million.
“Texas faces unique challenges when it comes to health care delivery, and Washington’s one-size-fits-all approach doesn’t fit our needs,” Perry said. “SB 7 provides state-based solutions to rising health care costs by providing millions in savings, rewarding innovation and improving the health care of Texans.”
Texas Rep. Lois Kolkhorst, R-Brenham, introduced the compacts bill as a separate piece of legislation and fought hard for its passage in the special session after seeing it stall at the end of the regular period.
“Health care spending crowds out funding for our schools, highways and public safety. That's why we need the health care compact,” Kolkhorst said. “Texans need a bigger say in how our health dollars are spent, a government closest to the people governs best."
Leo Linbeck III, a Houston businessman and one of the founders of the national Health Care Compacts Alliance, said Texas has struck a blow for self-governance, giving Texans an opportunity to shape its own health care system.
“Rather than forcing Texans to comply with a one-size-fits-all system designed by federal politicians and Washington D.C. bureaucrats, the health care compact will bring those decisions back to Texas, “ Linbeck said. “Americans want self-governance, especially in health care.”
Contact Mark Lisheron at 512-299-2318 or firstname.lastname@example.org or on Twitter at @marktxwatchdog.
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Photo of pills by flickr user Grumpy-Puddin, used via a Creative Commons license.