IV 
111TH CONGRESS 
1ST SESSION 
H. CON. RES. 78 
Expressing the support of the Congress regarding the need to facilitate 
State innovation in national health care reform. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 24, 2009 
Ms. BALDWIN (for herself, Mr. SESSIONS, Mr. PETRI, Mr. YOUNG of Alaska, 
Mr. BURTON of Indiana, Mr. LINDER, Mr. WU, Mr. BISHOP of Georgia, 
Mr. GENE GREEN of Texas, Mr. HOLT, and Mr. KIND) submitted the 
following concurrent resolution; which was referred to the Committee on 
Energy and Commerce 
CONCURRENT RESOLUTION 
Expressing the support of the Congress regarding the need 
to facilitate State innovation in national health care reform. 
Whereas there are 45,700,000 people who have been without 
health insurance coverage at some point during 2007 in 
the United States; 
Whereas, at any given point in time, between 13 and 20 per-
cent of the United States population is covered by Med-
icaid, a program administered by States according to 
broad Federal guidelines; 
Whereas the percentage of uninsured residents varies by 
more than 20 percentage points across the States; 
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•HCON 78 IH 
Whereas States want affordable health care that will provide 
meaningful coverage to their residents, and urge the Fed-
eral Government to lead a Federal-State partnership to 
reach that goal; 
Whereas State governments possess an ability to respond to 
and predict the health care needs of their residents with-
in the context of a Federal-State partnership; 
Whereas States have the unique flexibility have to meet vary-
ing social, political, economic, demographic, and market 
conditions in the various States; 
Whereas States, in the absence of national action, have taken 
the lead in health care reform, implementing new initia-
tives, passing legislation, and debating ambitious reform 
proposals; 
Whereas several States have already enacted comprehensive 
health care reform initiatives, and many more States are 
moving towards additional types of health care reform; 
Whereas at least 1 State has been successful at significantly 
lowering its uninsurance rate through State-level reforms; 
Whereas many more States have undertaken incremental ef-
forts that can provide important lessons for other States 
and for national policy across a broad range of issue 
areas, including payment reform, quality improvement, 
disease management, long-term care, cost containment, 
and coverage expansion; 
Whereas, even with national action, States can continue to 
play a critical role to supplement Federal action, ensur-
ing consumer protections and expanding available serv-
ices; 
Whereas Federal support and encouragement of States’ ini-
tiatives is key to making health care accessible to all; 
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•HCON 78 IH 
Whereas the national health care system can incorporate and 
apply lessons learned from successful State-level experi-
ments, both to improve national strategies enacted by 
Congress and to help prepare the way for future stages 
of reform; 
Whereas States should work in partnership with the Federal 
Government to achieve clear national goals and objectives 
for improving our health care system; 
Whereas States may have the ability to achieve national goals 
and objectives more quickly and effectively if permitted 
the flexibility when implementing aspects of national re-
form; 
Whereas States that object to segments of a proposed na-
tional reform effort may come to support that reform if 
they are permitted to make modifications, while commit-
ting to achieving objectives of reform; and 
Whereas there is strong bipartisan support for an approach 
to health reform that incorporates the principles of Cre-
ative Federalism: Now, therefore, be it 
Resolved by the House of Representatives (the Senate 
concurring), That the Congress commits to include, within 
legislation authorizing national health care reform, provi-
sions that facilitate State innovation and that— 
(1) promote the unique role of States as 
innovators in health care reform, recognizing their 
distinct competencies; 
(2) feature flexibility for States in implementing 
national goals and objectives for health care reform, 
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•HCON 78 IH 
taking into consideration varying political, economic, 
and market conditions; 
(3) facilitate States’ efforts to improve upon 
and expand the goals and objectives of national 
health reform; and 
(4) incorporate the principles of State innova-
tion espoused in the Health Partnership Act and 
Health Partnership Through Creative Federalism 
Act. 
Æ 
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