Health-care compact a promising idea

February 21, 2011

“The vehemence of the opposition to President Obama’s overhaul of health care has spawned an assortment of strategies for killing it,” Weekly Standard executive editor Fred Barnes wrote recently. “The newest and most ambitious would create a health care compact among the states and use it to switch control of health care programs from the federal government to the states.”

Interstate compacts aren’t a wild idea. They just haven’t been tapped for such a political purpose before. The authority for compacts was established in the Constitution (Article 1, Section 10), and more than 200 have been set up. One example: the agreement uniting Maryland, Virginia, and the District of Columbia to build and operate the Washington area’s Metro subway system.

An issue of interest to two or more states can lead to a compact. It works this way: State legislatures approve a proposal, the states agree on the parts of mutual concern (such as buying insurance across state lines), then the compact is dispatched to Washington for ratification by Congress and the president (though the need for White House assent isn’t spelled out in the Constitution). Ratification turns the compact into federal law.

OCPA supports this concept and will be discussing it at length in upcoming publications and public forums.