Health Care Compact

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This article is part of the Center for Media & Democracy's spotlight on front groups and corporate spin.

The Health Care Compact is an interstate compact proposed by the Health Care Compact Alliance, a section 501(c)(4) organization that does not disclose its funders.[1]

The Health Care Compact Alliance

The Alliance does not disclose its funders because it "respects the wishes of its donors to keep their identities confidential," but they claim not to "solicit or accept donations from any political party, pharmaceutical company or health insurance company." The Chairman of the Board is Eric O'Keefe, a private investor from Wisconsin, chairman and CEO of the Sam Adams Alliance and on the boards of Institute for Humane Studies, the Center for Competitive Politics and Wisconsin Club for Growth. The Vice Chairman is Leo Linbeck III, president and CEO of Aquinas Companies and co-founder and chairman of the advisory board of the Rice Education Entrepreneurship Program. Also an Officer of the Board is Michael Barnhart, the President of Sunshine Review.[2]

The Compact

The Health Care Compact Alliance claims the Health Care Compact would restore "authority and responsibility for health care regulation to the member states (except for military health care, which will remain federal), and provide... the funds to the states to fulfill that responsibility." It would keep the primary responsibility for regulation of health care in each member state, which state could then suspend and supercede federal healthcare regulations. Funding would come from the federal government in the form of mandatory spending not subject to annual appropriations and would be "based on the federal funds spent in their state on health care in 2010."[3]

Ties to ALEC

On November 30, 2011, the HCCA announced that ALEC adopted the Compact as model legislation. The bill was originally introduced in ALEC's Health and Human Services Task Force. After being approved there, it was sent to the Board of Directors where it was approved again and officially became model legislation. The Texas Public Policy Foundation played a significant role in backing the legislation during the ALEC legislative process. [4]

About ALEC
ALEC is a corporate bill mill. It is not just a lobby or a front group; it is much more powerful than that. Through ALEC, corporations hand state legislators their wishlists to benefit their bottom line. Corporations fund almost all of ALEC's operations. They pay for a seat on ALEC task forces where corporate lobbyists and special interest reps vote with elected officials to approve “model” bills. Learn more at the Center for Media and Democracy's, and check out breaking news on our site.

State Legislative Activity

As of March 2012, the Compact had been introduced in 13 states and adopted in Texas, Georgia, Oklahoma, and Missouri. There are currently 20 states actively considering the Compact. [4]


Arizona passed a Health Care Compact Bill, but it was vetoed by Arizona Governor Jan Brewer, who said the law, SB 1201, "violates the separation of powers requirement established by Article 3" of the Arizona Constitution and worried it "would result in additional fiscal challenges for our health care system."[5]


Georgia became the first state to make the Health Care Compact state law on April 20, 2011. An Atlanta Journal-Constitution article calls it "a measure that could make it possible for them to avoid implementation of the federal health care law" but notes that, "since any compact requires congressional approval, many see Georgia's move as largely symbolic." Georgia lawmakers passed the compact law but "never took a floor vote on a bill to begin planning for a Georgia-run insurance exchange" mandated by the Federal health care law "after tea party activists raised last-minute objections" to such a bill proposed by Governor Deal.[6]


The Indiana House of Representatives passed the Health Care Compact last week by a vote of 61-35, with four Democrats joining Republicans in support of the bill. The bill will move on to the Indiana Senate. [7]


In February 2012, Republicans on the Health and Human Services Committee voted to send to the floor House Bill 2520, which would authorize Kansas participation in the Interstate Health Care Compact. Sponsored by Jim Denning, HB2520, authorizing Kansas to join an interstate health care compact, passed by a vote of 80 to 37. The bill will have a final vote in the House on Wednesday and has yet to be introduced in the Kansas Senate. [8]


On February 28, 2011, State representative Eric Burlison and state Senator Brian Nieves introduced two identical health care compact bills (HB 423 and SB 367) in their respective houses of the Missouri General Assembly. [9] The Health Care Compact passed both Chambers of the State Legislature. HB 423 passed the House and the Senate. [10]


In Montana, a Health Care Compact bill passed the House of Representatives and a Senate committee.[11][12] Gov. Brian Scweitzer vtoed the bill. "HB 526 is a frivolous measure that does nothing at best, and at worst puts seniors, Montanans with disabilities, and children at risk," said the Governor. [13]

New Hampshire

On February 15, 2012 a Health Care Compact bill passed the House of Representatives in New Hampshire. The vote was a veto-proof 253-29. House Bill 1560 creates an interstate compact that would be effective upon adoption by two other states and approval by the U.S. Congress. "If this bill becomes law, New Hampshire would have to take over the entire administration of Medicare, Medicaid and other health care programs that are currently administered by the federal government," House Democratic Floor Leader Gary Richardson of Hopkinton said. [14]

North Dakota

The North Dakota House of Representatives failed to pass the Interstate Freedom Health Care Compact, with opponents on both sides of the aisle.[15]


SB 722 has passed the Oklahoma Senate and a House panel. The Oklahoma House sponsor of Senate Bill 722, Rep. Glen Mulready said he agreed to sponsor the bill after he heard a presentation on the subject while attending a meeting of the American Legislative Exchange Council in Washington.[16]


The Tennessee state House Health Committee is preparing to vote on a Health Care Compact bill, and in the meantime, an unidentified group has been making automated telephone calls to senior citizens misrepresenting the AARP position on the bill. "The robo-calls indicate that AARP has new information about the bill, HB 369, and urges seniors to ask their representatives to support it." The Tennessee AARP advocacy director, Shelly Courington, responded, "We do not support the Health Care Compact, and for someone to be sending out robo-calls saying that we do is a very serious concern."[17] On May 11, 2011 a Health Care Compact passed the Tennessee State Senate. [18]


In Texas, Gov. Perry signed the Health Care Bill on 7/18/11. Legislation that passes both the Texas House and Senate does not require a governor’s signature to become law. Gov. Rick Perry nonetheless signed the legislation to show his support for a cause that is gaining strength in other states. SB7, an omnibus health care bill that includes the HCC, passed the TX legislature on 6/27/11. The Health Care Compact Bill has been proposed in the Texas congress;[19]


In Utah, The Senate Workforce Services, Community and Economic Development Committee voted 4-2 Thursday to forward SB208 to the Utah Senate for its consideration, on February 23, 2012. The legislation, sponsored by Sen. Stuart Adams, R-Clearfield, would permit the state to enter an interstate Healthcare Compact. [20] SB208 was scheduled to heard by the Senate Health and Human Services Committee, where it was expected to fail. Instead Sen. Stuart Adams pulled it from the agenda and pitched it to the Workforce Services Committee, which approved it on a party line. The measure now heads to the Senate floor. [21]

Contact Information

Health Care Compact Alliance 3901 Courtland Circle Alexandria, VA 22305 Phone: (877) 710-5992 Email: Web:

Articles and Resources


  1. Health Care Compact Alliance About Us, organization website, accessed April 20, 2011
  2. Ibid.
  3. Health Care Compact Alliance The Compact, organization website, accessed April 20 2011
  4. 4.0 4.1 Health Care Compact Alliance, ALEC Adopts Health Care Compact as Model Legislation Sacramento Bee, November 30, 2011
  5. Dylan Smith Brewer vetoes birther, campus gun bills: Also vetoes health care compact law Tucson Sentinel, April 18, 2011
  6. Aaron Gould Sheinin and Carrie Teegardin Deal signs health compact bill into law, Atlanta Journal-Constitution, April 20, 2011
  7. KEVIN ALLEN, Bill would free state from health care law, WSBT, February 6, 2012
  8. Tim Carpenter, House Embraces Health Compact Bill,, February 21, 2012
  9. Missouri to Consider Joining Interstate Compact on Health Care,, February 7, 2011
  10. Missouri, Health Care Compact, accessed March 2, 2012
  11. Health Care Compact, accessed March 2, 2012
  12. Missoulian State Bureau GOP: Proposals address health care insurance cost, access, March 19, 2011
  13. Gov. Brian Schweitzer, OFFICE OF THE GOVERNOR, [1], May 12, 2011
  14. Matthew Spolar Representatives Approbate Health Care Compact, Concord Monitor, Feburary 16, 2012
  15. Kate Bommarito ND Interstate Freedom Health Care Compact Fails, Plains Daily, February 17, 2011
  16. Michael McNutt Oklahoma house panel approves measure to let state join health care group, The Oklahoman, April 5, 2011
  17. Laura Thornquist Who's Playing ‘Dirty Politics' with TN's Interstate Compact Bill? Public News Service, April 20, 2011
  18. Health Care Compact Passes Tennessee Senate , Heath Care Compact, May 18, 2011
  19. Emily Ramshaw From Texas to D.C., Medicaid Funding Debate Rages, Texas Tribune, April 13, 2011
  20. Marjorie Cortez, Healthcare Compact Bill Advances to the Senate, Deseret News, February 23, 2012
  21. KIRSTEN STEWART, Utah bid to opt out of health reform advances to state Senate,, February 23, 2012