Texas joins Missouri, Oklahoma and Georgia in historic health care compact


On Monday (July 18), Texas became the fourth American state to sign the Health Care Compact into law. The signature of Gov. Rick Perry brings the Lone Star State into an alliance that already consists of Missouri, Oklahoma and Georgia.

In a statement sent to CapitolBeatOK, Gov. Perry said, ““Texas faces unique challenges when it comes to health care delivery, and Washington’s one-size-fits-all approach doesn’t fit our needs. 

“Senate Bill 7 provides state-based solutions to rising health care costs by providing millions in savings, rewarding innovation and improving the health care of Texans.”

In an interview with CapitolBeatOK last week, Eric O’Keefe, a founder of the Heath Care Compact Alliance, was confident that Texas or Montana would be the next state to approve the compact. He describes the compact as “an agreement between participating states that restores authority and responsibility for health care regulation to member states. … The compact allows Texas to create its own health care policies by joining an interstate compact that supersedes prior federal law.”

O’Keefe’s colleague at the Health Care Compact Alliance, Vice Chairman Leo Linbeck III said today, “By passing S.B. 7 with state Rep. Lois Kolkhorst’s Health Care Compact language, the Texas Legislature has taken a big step toward addressing the fundamental problem with health care policy: a failed governance system.

“Rather than forcing Texans to comply with a one-size-fits-all system designed by federal politicians and Washington DC bureaucrats, the Health Care Compact will bring those decisions back to Texas. Americans want self-governance, especially in health care.”

Rep. Kolkhorst, in a statement circulated by the alliance, said, “I think Texans can better decide how to prioritize our health care than Congressmen from California, New York or Wisconsin.  States are in a better position to determine our own needs than a big, one-size-fits-all federal plan.

“Health care spending crowds out funding for our schools, highways and public safety.  That’s why we need the Health Care Compact.  Texans need a bigger say in how our health dollars are spent, a government closest to the people governs best.”

In addition to the four states where it is now law, the health care compact has been introduced in another 11 states. 

Montana may be the best prospect to become the fifth compact state. Colorado, Arizona and Tennessee are also possibilities, according to the alliance. In all, the health care compact is under discussion in 36 states. 

O’Keefe and alliance spokesmen emphasize that the compact is a tool governance, not a prescription for health care policy: “The way health care works in a member state is not prescribed in the compact. Who and what is covered as well as the level of regulation are determined by each state after the compact is ratified.”

The alliance is the major public policy initiative of the alliance, characterized in its literature as “a nonpartisan organization dedicated to providing Americans more influence over decisions that govern their health care.”

O’Keefe’s group has pressed for the Health Care Compact in an historical and constitutional context. 

As he has explained, “Interstate compacts have been used throughout U.S. history to allow states to coordinate in important policy areas. Authority for compacts was established in the Constitution (Article I, Section 10), and more than 200 such agreements are currently in effect. They are voluntary agreements between states that, when consented to by Congress, have the force of federal law.”

When she signed Oklahoma’s health compact bill this spring, Gov. Mary Fallin said, “Oklahoma is joining the Health Care Compact Alliance with the goal of gaining the flexibility to implement a program that meets our state’s specific health care needs without onerous unfunded mandates from Washington.”

In the Oklahoma Legislature, state Sen. Clark Jolley of Edmond and state Rep. Glen Mulready of Tulsa shepherd the compact to passage. 
Editor’s Note: Detailed stories about the heath care compact can be found on the CapitolBeatOK website, including here and here