Health Care Compacts Shift Choices from D.C. to Michigan

Capitol Confidential ^ | 5/20/2011 | Jack McHugh

[MichCapCon]

State Rep. Tom McMillin (R-Rochester Hills) has sent a memo to House colleagues inviting them to co-sponsor a multistate Health Care Compact he plans to introduce shortly. The measure has been introduced in 14 states, adopted by legislative bodies in several, signed into law in Georgia and Oklahoma, and submitted for governors' signatures in Missouri and Montana. If approved by Congress, it would make the federal “Patient Protection and Affordable Care Act” optional in the states that join the compact — and theoretically, the president’s signature is not required on that congressional approval.

Importantly, the Health Care Compact is much more than just an “Obamacare doesn’t apply here” measure. It would profoundly shift the balance of power between states and the federal government in health care regulations and programs by turning all of a state’s federal Medicaid and Medicare spending into a no-strings-attached block grant (indexed for future inflation and population growth). Member states would have primary responsibility for regulation of all nonmilitary health care goods and services in their state, plus health-related social welfare programs.

So, for example, if Michigan so chose, it could replace Medicare’s restrictions and price controls with a means-tested voucher-like insurance subsidy similar to that proposed nationally by Republican Congressman Rep. Paul Ryan. If our Legislature wanted to fix Medicaid’s broken promises by converting it into a “cash and counseling” program for the truly indigent, it could do so.

As McMillin puts it, “Michigan leaders understand Michigan’s needs better than Washington — this is all about who decides.”

[VanDeKoik]

Am I off here as I always thought that states could not create treaties or compacts with each other?