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| To enact section 3702.01 of the Revised Code to join | 1 |
| the Health Care Compact. | 2 |
| Section 1. That section 3702.01 of the Revised Code be | 3 |
| enacted to read as follows: | 4 |
| Sec. 3702.01. The "Health Care Compact" is hereby enacted | 5 |
| into law and entered into by this state as a party thereto with | 6 |
| any other state legally joining in the compact in substantially | 7 |
| the following form: | 8 |
| THE HEALTH CARE COMPACT | 9 |
| Whereas, the separation of powers, both between the branches | 10 |
| of the federal government and between federal and state authority, | 11 |
| is essential to the preservation of individual liberty; | 12 |
| Whereas, the United States Constitution creates a federal | 13 |
| government of limited and enumerated powers, and reserves to the | 14 |
| states or to the people those powers not granted to the federal | 15 |
| government; | 16 |
| Whereas, the federal government has enacted many laws that | 17 |
| have preempted state laws with respect to health care, and placed | 18 |
| increasing strain on state budgets, impairing other | 19 |
| responsibilities such as education, infrastructure, and public | 20 |
| safety; | 21 |
| Whereas, the member states seek to protect individual liberty | 22 |
| and personal control over health care decisions, and believe the | 23 |
| best method to achieve these ends is by vesting regulatory | 24 |
| authority over health care in the states; | 25 |
| Whereas, by acting in concert, the member states may express | 26 |
| and inspire confidence in the ability of each member state to | 27 |
| govern health care effectively; and | 28 |
| Whereas, the member states recognize that consent of the | 29 |
| United States congress may be more easily secured if the member | 30 |
| states collectively seek consent through an interstate compact; | 31 |
| NOW THEREFORE, the member states hereto resolve, and by the | 32 |
| adoption into law under their respective state constitutions of | 33 |
| this health care compact, agree, as follows: | 34 |
| SECTION I | 35 |
| DEFINITIONS | 36 |
| As used in this compact, unless the context clearly indicates | 37 |
| otherwise: | 38 |
| "Effective date" means the date upon which this compact shall | 39 |
| become effective for purposes of the operation of state and | 40 |
| federal law in a member state, which shall be the later of: | 41 |
| (a) The date upon which this compact shall be adopted under | 42 |
| the laws of the member state; and | 43 |
| (b) The date upon which this compact receives the consent of | 44 |
| congress pursuant to Article I, Section 10, of the United States | 45 |
| Constitution, after at least two member states adopt this compact. | 46 |
| "Health care" means care, services, supplies, or plans | 47 |
| related to the health of an individual and includes, but is not | 48 |
| limited to: | 49 |
| (a) Preventive, diagnostic, therapeutic, rehabilitative, | 50 |
| maintenance, or palliative care and counseling, service, | 51 |
| assessment, or procedure with respect to the physical or mental | 52 |
| condition or functional status of an individual or that affects | 53 |
| the structure or function of the body; | 54 |
| (b) Sale or dispensing of a drug, device, equipment, or other | 55 |
| item in accordance with a prescription; and | 56 |
| (c) An individual or group plan that provides, or pays the | 57 |
| cost of, care, services, or supplies related to the health of an | 58 |
| individual. | 59 |
| Except, "health care" does not include any care, services, | 60 |
| supplies, or plans provided by the United States department of | 61 |
| defense and the United States department of veterans affairs, or | 62 |
| provided to native Americans. | 63 |
| "Member state" means a state that is signatory to this | 64 |
| compact and that has adopted it under the laws of that state. | 65 |
| "Member state base funding level" means a number equal to the | 66 |
| total federal spending on health care in the member state during | 67 |
| federal fiscal year 2010. On or before the effective date, each | 68 |
| member state shall determine the member state base funding level | 69 |
| for its state, and that number shall be binding upon that member | 70 |
| state. The preliminary estimate of member state base funding level | 71 |
| for the state of Ohio is $35,043,000,000. | 72 |
| "Member state current year funding level" means the member | 73 |
| state base funding level multiplied by the member state current | 74 |
| year population adjustment factor multiplied by the current year | 75 |
| inflation adjustment factor. | 76 |
| "Member state current year population adjustment factor" | 77 |
| means the average population of the member state in the current | 78 |
| year less the average population of the member state in federal | 79 |
| fiscal year 2010, divided by the average population of the member | 80 |
| state in federal fiscal year 2010, plus 1. Average population in a | 81 |
| member state shall be determined by the United States census | 82 |
| bureau. | 83 |
| "Current year inflation adjustment factor" means the total | 84 |
| gross domestic product deflator in the current year divided by the | 85 |
| total gross domestic product deflator in federal fiscal year 2010. | 86 |
| Total gross domestic product deflator shall be determined by the | 87 |
| bureau of economic analysis of the United States department of | 88 |
| commerce. | 89 |
| SECTION 2 | 90 |
| PLEDGE | 91 |
| The member states shall take joint and separate action to | 92 |
| secure the consent of congress to this compact in order to return | 93 |
| the authority to regulate health care to the member states | 94 |
| consistent with the goals and principles articulated in this | 95 |
| compact. The member states shall improve health care policy within | 96 |
| their respective jurisdictions and according to the judgment and | 97 |
| discretion of each member state. | 98 |
| SECTION 3 | 99 |
| LEGISLATIVE POWER | 100 |
| The legislatures of the member states have the primary | 101 |
| responsibility to regulate health care in their respective states. | 102 |
| SECTION 4 | 103 |
| STATE CONTROL | 104 |
| Each member state, within its state, may suspend by | 105 |
| legislation the operation of all federal laws, rules, regulations, | 106 |
| and orders regarding health care that are inconsistent with the | 107 |
| laws and regulations adopted by the member state pursuant to this | 108 |
| compact. Federal and state laws, rules, regulations, and orders | 109 |
| regarding health care will remain in effect unless a member state | 110 |
| expressly suspends them pursuant to its authority under this | 111 |
| compact. For any federal law, rule, regulation, or order that | 112 |
| remains in effect in a member state after the effective date, that | 113 |
| member state shall be responsible for the associated funding | 114 |
| obligations in its state. | 115 |
| SECTION 5 | 116 |
| FUNDING | 117 |
| (a) Each federal fiscal year, each member state shall have | 118 |
| the right to federal monies up to an amount equal to its member | 119 |
| state current year funding level for that federal fiscal year, | 120 |
| funded by congress as mandatory spending and not subject to annual | 121 |
| appropriation, to support the exercise of member state authority | 122 |
| under this compact. This funding shall not be conditional on any | 123 |
| action of or regulation, policy, law, or rule being adopted by the | 124 |
| member state. | 125 |
| (b) By the start of each federal fiscal year, congress shall | 126 |
| establish an initial member state current year funding level for | 127 |
| each member state, based upon reasonable estimates. The final | 128 |
| member state current year funding level shall be calculated, and | 129 |
| funding shall be reconciled by congress based upon information | 130 |
| provided by each member state and audited by the United States | 131 |
| government accountability office. | 132 |
| SECTION 6 | 133 |
| INTERSTATE ADVISORY HEALTH CARE COMMISSION | 134 |
| (a) The interstate advisory health care commission is | 135 |
| established. The commission consists of members appointed by each | 136 |
| member state through a process to be determined by each member | 137 |
| state. A member state may not appoint more than two members to the | 138 |
| commission and may withdraw membership from the commission at any | 139 |
| time. Each commission member is entitled to one vote. The | 140 |
| commission shall not act unless a majority of the members are | 141 |
| present, and no action shall be binding unless approved by a | 142 |
| majority of the commission's total membership. | 143 |
| (b) The commission may elect from among its membership a | 144 |
| chairperson. The commission may adopt and publish bylaws and | 145 |
| policies that are not inconsistent with this compact. The | 146 |
| commission shall meet at least once a year, and may meet more | 147 |
| frequently. | 148 |
| (c) The commission may study issues of health care regulation | 149 |
| that are of particular concern to the member states. The | 150 |
| commission may make nonbinding recommendations to the member | 151 |
| states. The legislatures of the member states may consider these | 152 |
| recommendations in determining the appropriate health care | 153 |
| policies in their respective states. | 154 |
| (d) The commission shall collect information and data to | 155 |
| assist the member states in their regulation of health care, | 156 |
| including assessing the performance of various state health care | 157 |
| programs and compiling information on the prices of health care. | 158 |
| The commission shall make this information and data available to | 159 |
| the legislatures of the member states. Notwithstanding any other | 160 |
| provision in this compact, no member state shall disclose to the | 161 |
| commission the health information of any individual, nor shall the | 162 |
| commission disclose the health information of any individual. | 163 |
| (e) The commission shall be funded by the member states as | 164 |
| agreed to by the member states. The commission shall have the | 165 |
| responsibilities and duties as may be conferred upon it by | 166 |
| subsequent action of the respective legislatures of the member | 167 |
| states in accordance with the terms of this compact. | 168 |
| (f) The commission shall not take any action within a member | 169 |
| state that contravenes any state law of that member state. | 170 |
| SECTION 7 | 171 |
| CONGRESSIONAL CONSENT | 172 |
| This compact shall be effective upon its adoption by at least | 173 |
| two member states and consent of congress. This compact shall be | 174 |
| effective unless congress, in consenting to this compact, alters | 175 |
| the fundamental purposes of this compact, which are: | 176 |
| (a) To secure the right of the member states to regulate | 177 |
| health care in their respective states pursuant to this compact | 178 |
| and to suspend the operation of any conflicting federal laws, | 179 |
| rules, regulations, and orders within their states; and | 180 |
| (b) To secure federal funding for member states that choose | 181 |
| to invoke their authority under this compact, as prescribed by | 182 |
| section 5 above. | 183 |
| SECTION 8 | 184 |
| AMENDMENTS | 185 |
| The member states, by unanimous agreement, may amend this | 186 |
| compact from time to time without the prior consent or approval of | 187 |
| congress and any amendment shall be effective unless, within one | 188 |
| year, the congress disapproves that amendment. Any state may join | 189 |
| this compact after the date on which congress consents to the | 190 |
| compact by adoption into law under its state constitution. | 191 |
| SECTION 9 | 192 |
| WITHDRAWAL; DISSOLUTION | 193 |
| Any member state may withdraw from this compact by adopting a | 194 |
| law to that effect, but no such withdrawal shall take effect until | 195 |
| six months after the governor of the withdrawing member state has | 196 |
| given notice of the withdrawal to the other member states. A | 197 |
| withdrawing state shall be liable for any obligations that it may | 198 |
| have incurred prior to the date on which its withdrawal becomes | 199 |
| effective. This compact shall be dissolved upon the withdrawal of | 200 |
| all but one of the member states. | 201 |