State Health Care Compact an ObamaCare Repeal Idea

National   |   Steven Ertelt   |   Dec 29, 2010   |   4:18PM   |   Washington, DC

Next year, Republicans in Congress will float their legislation to repeal ObamaCare, though some suggest the legislation is not likely to succeed in overturning the controversial law.

With President Barack Obama still in office and Democrats controlling the U.S. Senate, an expected bill approved by the newly-minted prolife Republican majority in the House of Representatives would place pressure on Obama and Democrats leading up to the presidential elections but not likely be approved by either one.

Keeping that problem in mind, Weekly Standard editor Fred Barnes has a different approach he suggests could be a third option — in addition to the multiple lawsuits that are making their way through federal courts — for rolling back the pro-abortion, pro-rationing law.

The vehemence of the opposition to President Obama’s overhaul of health care has spawned an assortment of strategies for killing it. 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.

If that sounds like a long shot, it’s no more so than the other schemes for nullifying Obamacare. These include repeal by Congress or by constitutional amendment, lawsuits to strike down Obamacare’s individual mandate, and actions by governors and House Republicans to slow down its implementation.

Those are worthy efforts. But a health care compact would do more. If successful—a very big “if”—it would reduce the scope of Washington’s power. States, not Congress, the White House, or federal bureaucrats, would set the rules for health care from top to bottom, from Medicare and Medicaid to individual insurance policies.

And as ambitious as that sounds, it’s merely the initial goal of the group of conservative activists leading the compact drive. They want to use compacts to return other areas of federal control—the environment, drug and medical device regulation, education, to name three possibilities—to the states or even local governments.

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.

The idea sounds fine in theory and states are more frequently moving in the same direction of combating the problems at the federal level, but the rub with the proposal is that it requires approval by Congress and the president. While it would have a much better chance of getting signed into law than legislation to repeal ObamaCare, Obama and Democrats in the Senate could also stall a House-approved state compact bill for election or political reasons.

Barnes says the idea would give states more power in Washington and would put pressure on ObamaCare supporters from their state legislatures.

Backers of the health care compact figure they need more than 20 states to pressure Washington to go along. Their assumption is members of Congress (even Democrats who support Obamacare) would be inclined to vote for a formal request from their home state. Members who oppose Obama-care would vote for it as well.

Whether that happens it anyone’s guess, but any idea to combat the government takeover of the health care system and the eventual promotion of abortion funding at taxpayer expense and rationing of medical care is welcome.