Citations Affected: IC 12-16.5.
Synopsis: Health care compact. Conference committee report for EHB 1269. Establishes the
health care compact. Requires the securing of the consent of the United States Congress.
Specifies that the state legislature of each member state has the primary responsibility to regulate
health care in the member state's jurisdiction. Allows the governor to enter into the compact on
behalf of the state only after: (1) the budget committee reviews the compact and an
implementation plan developed by the budget agency; (2) the budget agency prepares an
implementation plan showing how Indiana will provide access to health care under the compact;
and (3) the budget agency presents the plan to the health finance commission. Specifies that
Indiana's participation in the compact does not include the administration of the federal Medicare
program unless the General Assembly takes action that specifically authorizes the inclusion of
Medicare in the compact. Allows member states of the compact to suspend all federal laws,
regulations, and orders concerning health care that are inconsistent with the laws and regulations
adopted by the member state under the compact, to the extent allowed under the Constitution of
the United States and the constitution of the member state. Creates the interstate advisory health
care commission consisting of individuals from member states. (This conference committee
report: (1) removes language exempting Medicare in the definition of "health care"; and
(2) adds language specifying that Indiana's participation in the compact does not include
the administration of the federal Medicare program unless the General Assembly takes
action that specifically authorizes the inclusion of Medicare in the compact.)
Effective: July 1, 2012.
Your Conference Committee appointed to confer with a like committee from the Senate upon Engrossed Senate Amendments to Engrossed House Bill No. 1269 respectfully reports that said two committees have conferred and agreed as follows to wit:
that the House recede from its dissent from all Senate amendments and that the House now concur in all Senate amendments to the bill and that the bill be further amended as follows:
Between the title and the enacting clause, begin a new paragraph and insert:
" Whereas, the separation of powers, both between the branches of the federal government and between federal and state authority, is essential to the preservation of individual liberty;
Whereas, the United States Constitution creates a federal government of limited and enumerated powers, and reserves to the states or to the people those powers not granted to the federal government;
Whereas, the federal government has enacted many laws that have preempted state laws with respect to health care, and placed increasing strain on state budgets, impairing other responsibilities such as education, infrastructure, and public safety;
Whereas, the member states seek to protect individual liberty and personal control over health care decisions, and believe the best method to achieve these ends is by vesting regulatory authority over health care in the states;
Whereas, by acting in concert, the member states may express and inspire confidence in the ability of each member state to govern health care effectively; and
Whereas, the member states recognize that consent of Congress may be more easily secured if the member states collectively seek consent through an interstate compact: Therefore, ".
have the right to federal monies in an amount up to the member
state current year funding level for the current year, funded by the
federal government as mandatory spending and that is not subject
to annual appropriation, to support the exercise of the member
state authority under the compact. The funding may not be
conditional on any action of or regulation, policy, law, or rule that
is being adopted by the member state and that is allowed under the
Constitution of the United States and the constitution of the
(b) By the start of each federal fiscal year, the federal United States Congress shall establish an initial member state current year funding level for each member state. The initial member state current year funding level must be based on a reasonable estimate. The final member state current year funding level shall be calculated and funding shall be reconciled by the federal United States Congress based on information provided by each member state and audited by the United States Government Accountability Office.
Sec. 5. The member states may fund the commission in a manner agreed upon by the member states.
Sec. 6. The member states may, by unanimous agreement, amend the compact without the prior consent or approval of the federal United States Congress, to the extent the amendment is allowed under the Constitution of the United States and the constitutions of the member states. Any amendment shall be effective unless, not later than one (1) year from the approval of the amendment, the federal United States Congress disapproves of the amendment.
Sec. 7. Any state may join the compact after the date of consent of the compact by the federal United States Congress if the state adopts the compact into law.
Sec. 8. (a) A member state may withdraw from the compact by doing the following:
(1) The member state's governor notifies other member states of the intent to withdraw from the compact at least six (6) months before the withdrawal may occur.
(2) The member state's legislature adopts legislation to withdraw from the compact.
(b) A member state withdrawing from the compact is liable for any obligations that the withdrawing state may have incurred prior to the date of which the withdrawal is effective.
Sec. 9. The compact shall be dissolved upon the withdrawal from the compact of all but one (1) member state.
Chapter 4. Interstate Advisory Health Care Commission
Sec. 1. (a) The interstate advisory health care commission is established.
(b) The commission consists of members appointed by each member state in a manner determined by each member state. A member state may not appoint more than two (2) members to the commission and may withdraw membership from the commission at any time.
(c) Each commission member is entitled to one (1) vote. The commission may not act unless a majority of the members are present, and an action is not binding unless approved by a majority of the commission's total membership.
Sec. 2. (a) The commission may do the following:
(1) Elect a chairperson from the commission's membership.
(2) Adopt and publish bylaws and policies that are consistent with the compact.
(3) Study issues of health care regulation that are of concern to the member states.
(4) Make non-binding recommendations to the member states, of which the state legislatures of the member states may consider in determining appropriate health care policies for the member state.
(b) The commission shall do the following:
(1) Meet at least one (1) time per calendar year.
(2) Collect information and data to assist member states in the regulation of health care, including assessing the performance of state health care programs and compiling information on the prices of health care.
(c) The commission shall make the information collected under this section available to the legislatures of member states.
(d) Legislatures of the member states may confer additional responsibilities and duties on the commission through legislative action in accordance with the terms of the compact.
(e) The commission may not take any action within a member state.
Sec. 3. A member state may not disclose personal health information of an individual to the commission. The commission may not disclose the personal health information of an individual.
Chapter 5. Participation in Compact
Sec. 1. Indiana's participation in the compact does not include the administration of Medicare (42 U.S.C. 1395 et seq.) unless the General Assembly takes action that specifically authorizes inclusion of the Medicare program in the compact.
(Reference is to EHB 1269 as reprinted printer's error February 29, 2012.)
Representative Brown T Senator Young R Michael
Representative Neese Senator Miller
House Conferees Senate Conferees