There are few policy initiatives that truly change the way government works, but HB 5 falls in that category. The constitutionally defined relationship between the states and the federal government has been under increasing assault since the beginning of the 20th century. The country is now experiencing the crescendo of federal overreach, particularly in EPA regulation and in health care. The interstate compact may prove to be the very tool needed for the states to use to restore federalism.
An interstate compact is an agreement between two or more states that is sent to Congress for ratification as required by Article I, Section 10 of the U.S. Constitution. Once ratified, the compact supercedes previous federal law. It is the states opportunity to write federal law.
The State of Texas will face a budgetary crisis in Medicaid funding in the next legislative session. Under current law, the legislature will have to come up with an additional $14-$15 billion in general revenue for that one program alone. Also under current law, the state has almost no flexibility in the program design, i.e., benefits or eligibility, to create a sustainable system.
HB 5, the Health Care Compact, would allow the flexibility the state needs and would return the authority and the funding for Medicaid to the state, should the state so decide. And, that is really what this is about. Who decides?
In the case of HB 5, its about who decides about your healthcare – a federal bureaucracy or the people of Texas and their elected state legislators. Texas is a beacon of hope for a nation in great need of hope renewed. In order to stoke that beacon brighter we need this reform. We can, and must, be the “city on a hill”. Texas needs HB 5.