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| To enact sections 190.01 and 190.02 of the Revised | 1 |
| Code to enter into the Health Care Compact. | 2 |
| Section 1. That sections 190.01 and 190.02 of the Revised | 3 |
| Code be enacted to read as follows: | 4 |
| Sec. 190.01. "The Health Care Compact" is hereby ratified, | 5 |
| enacted into law, and entered into by the state of Ohio as a party | 6 |
| to the compact with any other state that has legally joined in the | 7 |
| compact as follows: | 8 |
| Whereas, the separation of powers, both between the branches | 9 |
| of the Federal government and between Federal and State authority, | 10 |
| is essential to the preservation of individual liberty; | 11 |
| Whereas, the Constitution creates a Federal government of | 12 |
| limited and enumerated powers, and reserves to the States or to | 13 |
| the people those powers not granted to the Federal government; | 14 |
| Whereas, the Federal government has enacted many laws that | 15 |
| have preempted State laws with respect to Health Care, and placed | 16 |
| increasing strain on State budgets, impairing other | 17 |
| responsibilities such as education, infrastructure, and public | 18 |
| safety; | 19 |
| Whereas, the Member States seek to protect individual liberty | 20 |
| and personal control over Health Care decisions, and believe the | 21 |
| best method to achieve these ends is by vesting regulatory | 22 |
| authority over Health Care in the States; | 23 |
| Whereas, by acting in concert, the Member States may express | 24 |
| and inspire confidence in the ability of each Member State to | 25 |
| govern Health Care effectively; and | 26 |
| Whereas, the Member States recognize that consent of Congress | 27 |
| may be more easily secured if the Member States collectively seek | 28 |
| consent through an interstate compact; | 29 |
| NOW THEREFORE, the Member States hereto resolve, and by the | 30 |
| adoption into law under their respective State Constitutions of | 31 |
| this Health Care Compact, agree, as follows: | 32 |
| Sec. 1. Definitions. As used in this Compact, unless the | 33 |
| context clearly indicates otherwise: | 34 |
| "Commission" means the Interstate Advisory Health Care | 35 |
| Commission. | 36 |
| "Effective Date" means the date upon which this Compact shall | 37 |
| become effective for purposes of the operation of State and | 38 |
| Federal law in a Member State, which shall be the later of: | 39 |
| (a) the date upon which this Compact shall be adopted under | 40 |
| the laws of the Member State, and | 41 |
| (b) the date upon which this Compact receives the consent of | 42 |
| Congress pursuant to Article I, Section 10, of the United States | 43 |
| Constitution, after at least two Member States adopt this Compact. | 44 |
| "Health Care" means care, services, supplies, or plans | 45 |
| related to the health of an individual and includes but is not | 46 |
| limited to: | 47 |
| (a) preventive, diagnostic, therapeutic, rehabilitative, | 48 |
| maintenance, or palliative care and counseling, service, | 49 |
| assessment, or procedure with respect to the physical or mental | 50 |
| condition or functional status of an individual or that affects | 51 |
| the structure or function of the body, and | 52 |
| (b) sale or dispensing of a drug, device, equipment, or other | 53 |
| item in accordance with a prescription, and | 54 |
| (c) an individual or group plan that provides, or pays the | 55 |
| cost of, care, services, or supplies related to the health of an | 56 |
| individual, | 57 |
| except any care, services, supplies, or plans provided by the | 58 |
| United States Department of Defense and United States Department | 59 |
| of Veteran Affairs, or provided to Native Americans. | 60 |
| "Member State" means a State that is signatory to this | 61 |
| Compact and has adopted it under the laws of that State. | 62 |
| "Member State Base Funding Level" means a number equal to the | 63 |
| total Federal spending on Health Care in the Member State during | 64 |
| Federal fiscal year 2010. On or before the Effective Date, each | 65 |
| Member State shall determine the Member State Base Funding Level | 66 |
| for its State, and that number shall be binding upon that Member | 67 |
| State. The preliminary estimate of Member State Base Funding Level | 68 |
| for the State of Ohio is $35,043,000,000. | 69 |
| "Member State Current Year Funding Level" means the Member | 70 |
| State Base Funding Level multiplied by the Member State Current | 71 |
| Year Population Adjustment Factor multiplied by the Current Year | 72 |
| Inflation Adjustment Factor. | 73 |
| "Member State Current Year Population Adjustment Factor" | 74 |
| means the average population of the Member State in the current | 75 |
| year less the average population of the Member State in Federal | 76 |
| fiscal year 2010, divided by the average population of the Member | 77 |
| State in Federal fiscal year 2010, plus 1. Average population in a | 78 |
| Member State shall be determined by the United States Census | 79 |
| Bureau. | 80 |
| "Current Year Inflation Adjustment Factor" means the Total | 81 |
| Gross Domestic Product Deflator in the current year divided by the | 82 |
| Total Gross Domestic Product Deflator in Federal fiscal year 2010. | 83 |
| Total Gross Domestic Product Deflator shall be determined by the | 84 |
| Bureau of Economic Analysis of the United States Department of | 85 |
| Commerce. | 86 |
| Sec. 2. Pledge. The Member States shall take joint and | 87 |
| separate action to secure the consent of the United States | 88 |
| Congress to this Compact in order to return the authority to | 89 |
| regulate Health Care to the Member States consistent with the | 90 |
| goals and principles articulated in this Compact. The Member | 91 |
| States shall improve Health Care policy within their respective | 92 |
| jurisdictions and according to the judgment and discretion of each | 93 |
| Member State. | 94 |
| Sec. 3. Legislative Power. The legislatures of the Member | 95 |
| States have the primary responsibility to regulate Health Care in | 96 |
| their respective States. | 97 |
| Sec. 4. State Control. Each Member State, within its State, | 98 |
| may suspend by legislation the operation of all federal laws, | 99 |
| rules, regulations, and orders regarding Health Care that are | 100 |
| inconsistent with the laws and regulations adopted by the Member | 101 |
| State pursuant to this Compact. Federal and State laws, rules, | 102 |
| regulations, and orders regarding Health Care will remain in | 103 |
| effect unless a Member State expressly suspends them pursuant to | 104 |
| its authority under this Compact. For any federal law, rule, | 105 |
| regulation, or order that remains in effect in a Member State | 106 |
| after the Effective Date, that Member State shall be responsible | 107 |
| for the associated funding obligations in its State. | 108 |
| Sec. 5. Funding. | 109 |
| (a) Each Federal fiscal year, each Member State shall have | 110 |
| the right to Federal monies up to an amount equal to its Member | 111 |
| State Current Year Funding Level for that Federal fiscal year, | 112 |
| funded by Congress as mandatory spending and not subject to annual | 113 |
| appropriation, to support the exercise of Member State authority | 114 |
| under this Compact. This funding shall not be conditional on any | 115 |
| action of or regulation, policy, law, or rule being adopted by the | 116 |
| Member State. | 117 |
| (b) By the start of each Federal fiscal year, Congress shall | 118 |
| establish an initial Member State Current Year Funding Level for | 119 |
| each Member State, based upon reasonable estimates. The final | 120 |
| Member State Current Year Funding Level shall be calculated, and | 121 |
| funding shall be reconciled by the United States Congress based | 122 |
| upon information provided by each Member State and audited by the | 123 |
| United States Government Accountability Office. | 124 |
| Sec. 6. Interstate Advisory Health Care Commission. | 125 |
| (a) The Interstate Advisory Health Care Commission is | 126 |
| established. The Commission consists of members appointed by each | 127 |
| Member State through a process to be determined by each Member | 128 |
| State. A Member State may not appoint more than two members to the | 129 |
| Commission and may withdraw membership from the Commission at any | 130 |
| time. Each Commission member is entitled to one vote. The | 131 |
| Commission shall not act unless a majority of the members are | 132 |
| present, and no action shall be binding unless approved by a | 133 |
| majority of the Commission's total membership. | 134 |
| (b) The Commission may elect from among its membership a | 135 |
| Chairperson. The Commission may adopt and publish bylaws and | 136 |
| policies that are not inconsistent with this Compact. The | 137 |
| Commission shall meet at least once a year, and may meet more | 138 |
| frequently. | 139 |
| (c) The Commission may study issues of Health Care regulation | 140 |
| that are of particular concern to the Member States. The | 141 |
| Commission may make non-binding recommendations to the Member | 142 |
| States. The legislatures of the Member States may consider these | 143 |
| recommendations in determining the appropriate Health Care | 144 |
| policies in their respective States. | 145 |
| (d) The Commission shall collect information and data to | 146 |
| assist the Member States in their regulation of Health Care, | 147 |
| including assessing the performance of various State Health Care | 148 |
| programs and compiling information on the prices of Health Care. | 149 |
| The Commission shall make this information and data available to | 150 |
| the legislatures of the Member States. Notwithstanding any other | 151 |
| provision in this Compact, no Member State shall disclose to the | 152 |
| Commission the health information of any individual, nor shall the | 153 |
| Commission disclose the health information of any individual. | 154 |
| (e) The Commission shall be funded by the Member States as | 155 |
| agreed to by the Member States. The Commission shall have the | 156 |
| responsibilities and duties as may be conferred upon it by | 157 |
| subsequent action of the respective legislatures of the Member | 158 |
| States in accordance with the terms of this Compact. | 159 |
| (f) The Commission shall not take any action within a Member | 160 |
| State that contravenes any State law of that Member State. | 161 |
| Sec. 7. Congressional Consent. This Compact shall be | 162 |
| effective on its adoption by at least two Member States and | 163 |
| consent of the United States Congress. This Compact shall be | 164 |
| effective unless the United States Congress, in consenting to this | 165 |
| Compact, alters the fundamental purposes of this Compact, which | 166 |
| are: | 167 |
| (a) To secure the right of the Member States to regulate | 168 |
| Health Care in their respective States pursuant to this Compact | 169 |
| and to suspend the operation of any conflicting federal laws, | 170 |
| rules, regulations, and orders within their States; and | 171 |
| (b) To secure Federal funding for Member States that choose | 172 |
| to invoke their authority under this Compact, as prescribed by | 173 |
| Section 5 above. | 174 |
| Sec. 8. Amendments. The Member States, by unanimous | 175 |
| agreement, may amend this Compact from time to time without the | 176 |
| prior consent or approval of Congress and any amendment shall be | 177 |
| effective unless, within one year, the Congress disapproves that | 178 |
| amendment. Any State may join this Compact after the date on which | 179 |
| Congress consents to the Compact by adoption into law under its | 180 |
| State Constitution. | 181 |
| Sec. 9. Withdrawal; Dissolution. Any Member State may | 182 |
| withdraw from this Compact by adopting a law to that effect, but | 183 |
| no such withdrawal shall take effect until six months after the | 184 |
| Governor of the withdrawing Member State has given notice of the | 185 |
| withdrawal to the other Member States. A withdrawing State shall | 186 |
| be liable for any obligations that it may have incurred prior to | 187 |
| the date on which its withdrawal becomes effective. This Compact | 188 |
| shall be dissolved upon the withdrawal of all but one of the | 189 |
| Member States. | 190 |
| Sec. 190.02. Not later than thirty days after "The Health | 191 |
| Care Compact" entered into under section 190.01 of the Revised | 192 |
| Code is ratified by the United States congress, the governor shall | 193 |
| appoint a member to the interstate advisory health care commission | 194 |
| created under the compact. The governor shall fill a vacancy not | 195 |
| later than thirty days after the vacancy occurs. | 196 |