Center for Community and Economy Newsletter – Feb. 16, 2012

1. Set Our Health Care System Free

By Matthew Piccolo

Since Obamacare became law in 2010, states have been doing all they can to avoid its overreaching hand. They have filed lawsuits, requested waivers, passed legislation and identified loopholes in the law.

Many states are pursuing another option for regaining control of health care – the Health Care Compact, which would give states primary regulatory authority over health care policy. Four states have already signed the compact into law, and 12 others have introduced it.

Why should states control health care policy? The national health care industry is far too large and complex for a single government (i.e., the federal government) to manage. An agency in Washington trying to regulate and coordinate the minutiae of a $2.3 trillion industry that involves more than 300 million people is going to end up doing more damage than good. Indeed, the result of 2,688 pages of Medicare and Medicaid regulations is a one-size-fits-all, top-down approach that has led to soaring health care costs.

Pushing responsibility for health care policy down to the states would make government’s role much more manageable because of the smaller size and scope of the industry on the state level. States could find local solutions to local problems, potentially lowering costs. Of course, each state’s success would depend upon the wisdom of elected officials in each state, but at least those making policy would be more familiar with the people’s needs and priorities and would be more accountable to them.

Because Utahns value fiscal prudence and free markets, giving the state authority over health care would likely lead to less government and lower costs, and also more innovative solutions that are currently difficult to put in place. For example, Utah could adopt the Legislature’s recent innovations to streamline the state’s Medicaid program without first needing to obtain a waiver from the federal government, which may never come.

Interstate compacts, as allowed by Article I of the U.S. Constitution, are agreements made between two or more states to achieve a specific purpose. For example, states have entered a compact to allow a driver’s license from one state to remain valid while the driver travels through other states. Currently, more than 200 compacts exist among the states, and Congress has approved 90 of them.

The Health Care Compact would give all participating states primary regulatory authority over health care along with federal block grants, which would amount to an estimated $4.1 billion per year for Utah. Here are the main components of the Health Care Compact:

• States would have primary control to regulate all non-military health care goods and services in their state
• States could suspend federal health care regulations
• States would receive federal funds each year based on the amount of federal health care dollars spent in their state in 2010 (estimated at $4.1 billion for Utah), adjusted annually for changes in population and inflation
• Member states and Congress would need to approve the compact
• Member states would be able to amend the compact with approval of other members and without further congressional consent
• Member states could withdraw from the compact at any time

Senator Stuart Adams (R-Layton) is sponsoring SB 208, a bill that would allow Utah to join the Health Care Compact. Passing this bill would be an important step in bringing health care decisions back to the state, where they belong.

The author, Matthew C. Piccolo, M.P.P., is a policy analyst with Sutherland Institute.


2. Capitol Daily Video: Health Care Compact

By Alexis Young 

Today’s video addresses SB 208, the Health Care Compact. Watch below to hear what the sponsor, Senator Stuart Adams (R-Layton), said about the bill, as well as comments from Stan Rasmussen, director of public affairs at Sutherland Institute.

Visit the Sutherland Daily blog ( to see the video.


3. Capitol Daily Video: Gov. Herbert Announces UCAIR Initiative

By Dave Buer

Utah Governor Gary Herbert has announced an educational and partnership effort to encourage Utahns to change their habits voluntarily to reduce air pollution across the state.

Visit the Sutherland Daily blog ( to see our video report to learn more about the governor’s initiative and to hear what Derek Monson, Sutherland’s director of policy, had to say about it.