IA 
114TH CONGRESS 
1ST SESSION 
H. J. RES. 50 
Granting the consent of Congress to the Health Care Compact. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 12, 2015 
Mr. COLLINS of Georgia introduced the following joint resolution; which was 
referred to the Committee on the Judiciary 
JOINT RESOLUTION 
Granting the consent of Congress to the Health Care 
Compact. 
Resolved by the Senate and House of Representatives
of the United States of America in Congress assembled, 
CONGRESSIONAL CONSENT 
SECTION 1. Except as provided in section 2, Congress 
hereby consents to the Health Care Compact. The Com-
pact reads as follows: 
‘‘SECTION 1. DEFINITIONS. 
‘‘As used in this Compact, unless the context clearly 
indicates otherwise: 
‘‘(1) ‘Commission’ means the Interstate Advi-
sory Health Care Commission. 
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‘‘(2) ‘Effective Date’ means the date upon 
which this Compact shall become effective for pur-
poses of the operation of State and Federal law in 
a Member State, which shall be the later of— 
‘‘(A) the date upon which this Compact 
shall be adopted under the laws of the Member 
State; or 
‘‘(B) the date upon which this Compact re-
ceives the consent of Congress pursuant to Arti-
cle I, Section 10, of the United States Constitu-
tion, after at least two Member States adopt 
this Compact. 
‘‘(3) ‘Health Care’ means care, services, sup-
plies, or plans related to the health of an individual 
and includes but is not limited to— 
‘‘(A) preventive, diagnostic, therapeutic, 
rehabilitative, maintenance, or palliative care 
and counseling, service, assessment, or proce-
dure with respect to the physical or mental con-
dition or functional status of an individual or 
that affects the structure or function of the 
body; 
‘‘(B) sale or dispensing of a drug, device, 
equipment, or other item in accordance with a 
prescription; and 
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‘‘(C) an individual or group plan that pro-
vides, or pays the cost of, care, services, or sup-
plies related to the health of an individual, 
except any care, services, supplies, or plans provided 
by the United States Department of Defense and 
United States Department of Veterans Affairs, or 
provided to Native Americans. 
‘‘(4) ‘Member State’ means a State that is sig-
natory to this Compact and has adopted it under the 
laws of that State. 
‘‘(5) ‘Member State Base Funding Level’ 
means a number equal to the total Federal spending 
on Health Care in the Member State during Federal 
fiscal year 2010. On or before the Effective Date, 
each Member State shall determine the Member 
State Base Funding Level for its State, and that 
number shall be binding upon that Member State. 
‘‘(6) ‘Member State Current Year Funding 
Level’ means the Member State Base Funding Level 
multiplied by the Member State Current Year Popu-
lation Adjustment Factor multiplied by the Current 
Year Inflation Adjustment Factor. 
‘‘(7) ‘Member State Current Year Population 
Adjustment Factor’ means the average population of 
the Member State in the current year less the aver-
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age population of the Member State in Federal fiscal 
year 2010, divided by the average population of the 
Member State in Federal fiscal year 2010, plus 1. 
Average population in a Member State shall be de-
termined by the United States Census Bureau. 
‘‘(8) ‘Current Year Inflation Adjustment Fac-
tor’ means the Total Gross Domestic Product 
Deflator in the current year divided by the Total 
Gross Domestic Product Deflator in Federal fiscal 
year 2010. Total Gross Domestic Product Deflator 
shall be determined by the Bureau of Economic 
Analysis of the United States Department of Com-
merce. 
‘‘SEC. 2. PLEDGE. 
‘‘The Member States shall take joint and separate ac-
tion to secure the consent of the United States Congress 
to this Compact in order to return the authority to regu-
late Health Care to the Member States consistent with 
the goals and principles articulated in this Compact, the 
Member States shall improve Health Care policy within 
their respective jurisdictions and according to the judg-
ment and discretion of each Member State. 
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‘‘SEC. 3. LEGISLATIVE POWER. 
‘‘The legislatures of the Member States have the pri-
mary responsibility to regulate Health Care in their re-
spective States. 
‘‘SEC. 4. STATE CONTROL. 
‘‘Each Member State, within its State, may suspend 
by legislation the operation of all Federal laws, rules, regu-
lations, and orders regarding Health Care that are incon-
sistent with the laws and regulations adopted by the Mem-
ber State pursuant to this Compact. Federal and State 
laws, rules, regulations, and orders regarding Health Care 
will remain in effect unless a Member State expressly sus-
pends them pursuant to its authority under this Compact. 
For any Federal law, rule, regulation, or order that re-
mains in effect in a Member State after the Effective 
Date, that Member State shall be responsible for the asso-
ciated funding obligations in its State. 
‘‘SEC. 5. FUNDING. 
‘‘(a) Each Federal fiscal year, each Member State 
shall have the right to Federal monies up to an amount 
equal to its Member State Current Year Funding Level 
for that Federal fiscal year, funded by Congress as man-
datory spending and not subject to annual appropriation, 
to support the exercise of Member State authority under 
this Compact. This funding shall not be conditional on any 
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action of or regulation, policy, law, or rule being adopted 
by the Member State. 
‘‘(b) By the start of each Federal fiscal year, Con-
gress shall establish an initial Member State Current Year 
Funding Level for each Member State, based upon reason-
able estimates. The final Member State Current Year 
Funding Level shall be calculated, and funding shall be 
reconciled by the United States Congress based upon in-
formation provided by each Member State and audited by 
the United States Government Accountability Office. 
‘‘SEC. 6. INTERSTATE ADVISORY HEALTH CARE COMMIS-
SION. 
‘‘(a) The Interstate Advisory Health Care Commis-
sion is established. The Commission consists of members 
appointed by each Member State through a process to be 
determined by each Member State. A Member State may 
not appoint more than two members to the Commission 
and may withdraw membership from the Commission at 
any time. Each Commission member is entitled to one 
vote. The Commission shall not act unless a majority of 
the members are present, and no action shall be binding 
unless approved by a majority of the Commission’s total 
membership. 
‘‘(b) The Commission may elect from among its mem-
bership a Chairperson. The Commission may adopt and 
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publish bylaws and policies that are not inconsistent with 
this Compact. The Commission shall meet at least once 
a year, and may meet more frequently. 
‘‘(c) The Commission may study issues of Health 
Care regulation that are of particular concern to the Mem-
ber States. The Commission may make non-binding rec-
ommendations to the Member States. The legislatures of 
the Member States may consider these recommendations 
in determining the appropriate Health Care policies in 
their respective States. 
‘‘(d) The Commission shall collect information and 
data to assist the Member States in their regulation of 
Health Care, including assessing the performance of var-
ious State Health Care programs and compiling informa-
tion on the prices of Health Care. The Commission shall 
make this information and data available to the legisla-
tures of the Member States. Notwithstanding any other 
provision in this Compact, no Member State shall disclose 
to the Commission the health information of any indi-
vidual, nor shall the Commission disclose the health infor-
mation of any individual. 
‘‘(e) The Commission shall be funded by the Member 
States as agreed to by the Member States. The Commis-
sion shall have the responsibilities and duties as may be 
conferred upon it by subsequent action of the respective 
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legislatures of the Member States in accordance with the 
terms of this Compact. 
‘‘(f) The Commission shall not take any action within 
a Member State that contravenes any State law of that 
Member State. 
‘‘SEC. 7. CONGRESSIONAL CONSENT. 
‘‘This Compact shall be effective on its adoption by 
at least two Member States and consent of the United 
States Congress. This Compact shall be effective unless 
the United States Congress, in consenting to this Com-
pact, alters the fundamental purposes of this Compact, 
which are— 
‘‘(1) to secure the right of the Member States 
to regulate Health Care in their respective States 
pursuant to this Compact and to suspend the oper-
ation of any conflicting Federal laws, rules, regula-
tions, and orders within their States; and 
‘‘(2) to secure Federal funding for Member 
States that choose to invoke their authority under 
this Compact, as prescribed by Section 5 above. 
‘‘SEC. 8. AMENDMENTS. 
‘‘The Member States, by unanimous agreement, may 
amend this Compact from time to time without the prior 
consent or approval of Congress and any amendment shall 
be effective unless, within one year, the Congress dis-
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approves that amendment. Any State may join this Com-
pact after the date on which Congress consents to the 
Compact by adoption into law under its State Constitu-
tion. 
‘‘SEC. 9. WITHDRAWAL; DISSOLUTION. 
‘‘Any Member State may withdraw from this Com-
pact by adopting a law to that effect, but no such with-
drawal shall take effect until six months after the Gov-
ernor of the withdrawing Member State has given notice 
of the withdrawal to the other Member States. A with-
drawing State shall be liable for any obligations that it 
may have incurred prior to the date on which its with-
drawal becomes effective. This Compact shall be dissolved 
upon the withdrawal of all but one of the Member 
States.’’. 
AGENCIES FOR WHICH CONSENT IS NOT GRANTED 
SEC. 2. (a) IN GENERAL.—Notwithstanding the con-
sent to the Health Care Compact granted under section 
1, the powers granted to Member States under sections 
3, 4, and 5 of the Health Care Compact shall not apply 
with regard to the agencies listed under subsection (b), 
and the Member State Base Funding Level and Member 
State Current Year Funding Level shall not include funds 
spent by such agencies. 
(b) EXCLUDED AGENCIES.—The agencies to which 
subsection (a) applies are as follows: 
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(1) The National Institutes for Health. 
(2) The Centers for Disease Control and Pre-
vention. 
(3) The Food and Drug Administration. 
Æ 
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