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Local legislator unveils interstate health care compact bill

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As uncertainty and confusion swirls around federal health reform, a Springfield state legislator has introduced a bill that could allow Missouri to gut federal health reform and start over.

Missouri Rep. Eric Burlison, R-Springfield, introduced House Bill 423 earlier this month, and held a news conference about the bill Feb. 8 in the state capitol.

The bill would pave the way for Missouri to join at least 30 other states in discussions about creating an interstate health care compact.

Compacts, which must be approved by Congress, give participating states the authority to regulate certain issues, with the states’ laws superceding any previous and future related laws passed by Congress, Burlison said.

“More than 200 compacts are in existence between Missouri and other states right now,” Burlison said.

One is a nursing compact that allows nurses who are licensed in other states to practice in Missouri during emergencies, he said, while another – the International Fuel Tax Agreement – is an interstate commerce agreement for the trucking industry.

While the health care compact legislation may be in its infancy, Burlison said he has heard from dozens of constituents who support the effort and are excited about it, namely because they don’t believe the Constitution allows the federal government to require citizens to purchase health coverage or to regulate it, and they believe health care regulation should be handled by state governments.

Burlison learned of the interstate health care compact during a December meeting of the American Legislative Exchange Council, an organization that supports federalism and smaller government, according to

In theory, if the compact legislation passes in Missouri and is approved by Congress, the state legislature could make changes to reform, including elimination of mandated coverage even when there are pre-existing conditions and the requirement that insurers cover people until age 26, Burlison said.

He said the compact also would give each participating state access to federal funds set aside for health care.

The formula for that funding would be based on each state’s annual health care cost, average population and total gross domestic product deflator, Burlison said.

He noted that the compact plan wouldn’t affect Veterans Administration hospitals or the military’s Tricare Plan. He also reiterated that the compact plan isn’t focused on allowing the purchase of insurance across state lines.

“I’ve heard from a number of insurance companies that were against it because they assumed it was a compact to purchase insurance across state lines, but that is not what this is,” he said. “If the compact passes, we could pass laws to do that, but that is not what this is about.”

Burlison said the bill aims to explore what’s best for Missouri citizens and businesses.

“I believe the constituents and citizens would have a much greater voice in how (health reform) would be crafted on the state level than they did with the bill in Washington,” he said.

John Putnam, Jasper Country Republican Chairman and Missouri state coordinator for the Tea Party Patriots, supports the bill because he believes it would benefit small businesses by keeping health coverage premiums down, instead of hiking them up, as he believes the federal law will do as it is written.

“Expanding coverage to that degree would cause everyone’s premiums to go up and it will be more expensive for everyone, including small-business owners,” said Putnam, a retired third-generation business owner who operated Four State Supply Co., founded by his grandfather more than a century ago, until selling it in 1999.

State Rep. Sara Lampe, D-Springfield, believes the health care compact is a moot point, because it would require both House and Senate approval, and the Democrat-controlled U.S. Senate already has rejected attempts to overturn or alter federal health reform.

“When you look at the process, you have to ask if it is even possible to get this through,” Lampe said. “The Democratic Senate will not pass it, so it is a waste of time and will not go anywhere.”

Lampe said there is agreement among state legislators that creating jobs and balancing the budget are priorities this session, which leads her to question why this is being pursued.

“We need to be doing things that will help Missourians right now,” Lampe said.

Putnam, however, disagrees with Lampe’s assessment.

“I think (the U.S.) Senate might find it a welcome relief to move the health care issue back to the states,” Putnam said. “It would take the heat off of them.”

It could be a while before Putnam knows if he’s right. The health care compact bill will next move to committee for further discussion.

According to, there is no hearing scheduled for the bill, which after two readings was referred to the Health Care Policy Committee on Feb. 10.[[In-content Ad]]


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