by Pondering Penguin, this column originally appeared here.
Texas State Rep Lois Kolkhorst is chairwoman of the Public Health Committee. As the Chair of the House Committee on Public Health, she helps manage the state’s multi-billion dollar health care system and works to set priorities for the Health and Human Services Commission, which oversees thousands of state employees at five state agencies.
Rep Kolkhorst sponsored HB5 – Relating to the Interstate Health Care Compact and it has been voted out of committee on a vote of 5-0. By coming together with other states, Texas can manage the state’s Medicaid mandates as the costs rise in the coming years.
According to Texas Public Policy Foundation, the coming budget obligations for Medicaid in Texas will be staggering.
As legislators are well aware, Article II has consumed an increasingly larger percentage of the state’s budget, with Medicaid demanding the lion’s share. It is also the least flexible due to the restraints placed on Medicaid by the federal government. Recent changes in federal law with the passage of the Patient Protection Affordable Care Act (PPACA) removed most of the remaining options.
Texas general revenue Medicaid spending, after adjustments for inflation and population, will increase 866 percent between 2009 and 2040. Meaningful opportunities to stem the growth of health care spending are hard to come by because the Legislature has been hamstrung by certain provisions in the Patient Protection and Affordable Care Act and by the acceptance of ARRA funds that restrict lawmakers from making significant changes to Article II, particularly with regard to Medicaid.
Rep Kolkhorst believes that joining in with other states with the Interstate Compact option, it may be the only constitutional shield to be found to fight Obamacare. States can manage their needs better than the federal government. Currently there are 18 states coming together, with the potential for 12 more. After passing in the State Legislature, then the bill would be sent to Congress where it would be voted on. Every state has to work within the same perimeters. Block grants would be distributed.
With the current budget shortfalls facing every state, Interstate Compacts make sense.