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Ohio joining interstate compact would render federal health care plan moot

Special to the Legal News

Published: March 20, 2017

As Republicans in Congress took their first stab at dismantling Obamacare, members of an Ohio House of Representatives committee took a first look at a bill that proposes the Buckeye State join an interstate Health Care Compact.

The agreement among states would allow members to protect individual liberty and personal control over health care policy for their citizens, according to analysis provided by the Ohio Legislative Service Commission.

It would accomplish the intended effect by making member individual state legislatures primarily responsible for health care regulation within their respective jurisdictions.

Additionally, the compact authorizes a member state to suspend the operation of any federal law, rule, regulation, or order regarding health care that is inconsistent with laws and regulations adopted under the agreement.

Republican lawmaker and sponsor of House Bill 85, Rep. Wes Retherford of Hamilton, said Ohio's participation in the compact offers multiple advantages.

"We would be able to make adjustments to programs on a regular basis, if needed, without continually turning to the federal government for approval," he told fellow House members seated on the Federalism and Interstate Relations Committee. "We would be able to adopt a system or set of systems that we would have local control over, giving us the ability to directly represent our constituents and allow us to adopt practices that would work best for Ohio.

"As we all know, a one-size-fits-all approach is not always the best practice. What may work in California won't necessarily work in Ohio. We can keep what works and change what isn't working."

The compact, currently comprising nine states, stipulates that member states be awarded federal money up to an amount equal to the member state's current year funding level for the federal fiscal year.

For Ohio, that's an inflation adjusted $35 billion, based on 2010 spending.

"Many have expressed concerns that under Congress, a block grant program can result in cuts to various programs because of the ever changing ability to fund the block grants," Retherford said. "Under the Healthcare Compact, our funding to Ohio, along with every other state can only be changed to reflect population and inflation, thus protecting us from cuts from the federal budget, and also not punishing fiscal prudence and ingenuity through a 'use it or lose It' scenario."

What's more - the compact does not rely on congressional Republicans' efforts at "Repeal and Replace," the lawmaker said.

"We would have a more direct control over federal spending in health care," he argued. "This is not a use it or lose it proposition, so if Ohio can effectively devise a system that only uses (for example) $25 billion, we would theoretically save $7 billion at the federal level.

"However, when the next year rolls around, the number of dollars available will still be $35 billion adjusted for inflation and population."

Much like the Great Lakes Compact, such an agreement between two or more states must be approved by a simple majority of Congress.

Retherford explained that the ability for states to enter into compacts is outlined in Article 1, Section 10 of the U.S. Constitution.

Another provision of the compact would establish the Interstate Advisory Health Care Commission, consisting of representatives selected by member states.

Ohio is among six states considering legislation proposing entry to the compact.

Fourteen fellow House members have joined Retherford to cosponsor HB 85, which had not been scheduled for subsequent hearing as of publication.

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