by Jim Vetter, Pennsylvania Tenth Amendment Center

There are several solutions in the marketplace of ideas on how to address the Federal Government’s unconstitutional over-reach into Health Care with the Patient Protection and Affordable Care Act” (PPACA) or ObamaCare.  One such idea is the Health Care Compact .  Under the proposal, any groups of States would seek Congressional Consent to regulate Health Care in their States.  If approved by Congress, member states would have the right to Federal monies up to a preset amount listed in the table of Member State Base Funding Levels.  States would then use those Federal monies to implement health care in accordance with Federal laws and any State laws approved under the Compact.

The Health Care Compact is a well-intended effort to return health care decisions to the States.   However, is it the most effective method in keeping with the principles of limited government and Federalism?  Consider the following.

Congressional Consent

Why implement a structure that requires Consent of Congress and the Federal Government in this instance?  Aren’t these the very entities that gave us ObamaCare and are the root of the larger problem in America?   How likely are they to just give up their entrenched power?  If history is a judge, not likely. 

Even if there is a friendly majority in the Federal House and Senate, Congressional composition will certainly change over time as it has in the past.  Thus there is no assurance that this mechanism will be available consistently going forward.  Further, there are no protections against withdrawal of Consent by Congress in the proposed Contract language.

More fundamentally, consent should not be necessary as the Federal Government has no Constitutional Authority over Health Care.  There is no specific power in Article I, Section 8 of the US Constitution giving Congress the power to dictate on health care.  Period.  The Compact in essence recognizes the Federal Government’s unconstitutional overreach in Health Care and asks for permission to administer it at the State level.  Are we willing to, in essence, surrender on this matter and become administrative vassals like States are in Europe?  There is no reason to surrender our sovereign rights to manage our health care decisions to the Federal Government.  We don’t need consent from Washington D.C. !

Compact Structure

Why do the States need to create an interstate Compact of two or more states in this situation?  Under the Constitution, the individual States have rights already under the 10th Amendment to manage their affairs, and don’t need a Compact to exercise their rights.  Creating a new multi-state compact structure is new hurdle that moves away from the intent of the 10th Amendment, and effectively weakens the 10th Amendment.  Further, under the proposed language any one state that withdraws from an existing Compact will result in dissolution of the entire Compact that would leave the other States high and dry.  Can States afford to put their future at risk based upon how the political environment may change in the future with another State in the Compact?  This is hardly a sustainable solution.  Finally, implementing the Compact will likely create a new level of administrative bureaucracy, which runs counter to the goal of reducing the size of government.

Federal Dependency

The Health Care Compact further entrenches the States into dependency on the Federal government by seeking guaranteed federal monies.  This will result in the same “addiction” to Federal monies as Federal highway funds.  How often have legislators and citizens lamented their dependence on those monies and their inability to stand up against Washington on issues because of the ever-standing threat that highway funds will be withdrawn?  Why would we seek a solution for health care that repeats this mistake and makes the States even more dependent upon funding from Washington?  This funding mechanism would be forging more chains of bondage to all-to-willing masters in Washington.

The 10th Amendment Solution

The States, individually and in groups, already have the power to take back health care under the 10th Amendment to the US Constitution.  Lest we forget:

“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people”

Health Care is not one of the limited enumerated powers under Article I, Section 8 of the Constitution.  It is simply a matter of having the courage, will and fortitude to stand tall and say “NO” to the Federal Government.  State Legislatures, Governors and the People should use their existing Constitutional Authority under the US Constitution to redress the unconstitutional overreach by the Federal Government, including Obamacare, thru all the existing remedies available:

  • Passing legislation that nullifies ObamaCare and sets up an individual state framework for health care consistent with the Constitution, values and will of the People in each state.
  • State Interposition between the Federal Government and the People of their State to halt implementation of ObamaCare within their State boundaries.
  • Heightened grassroots and citizen activism in their home States and Washington D.C.
  • Continued support for the Attorneys General lawsuit.

Many states have already taken these Constitutional steps on behalf of themselves and their citizens to reassert sovereignty, and with regard to Health Care in particular.  North Dakota recently passed strong legislation up through their Governor.  This legislation can be reviewed at the 10th Amendment Center website.

Again, the Health Care Compact proposal is a well-intentioned effort, and those supporting it are our friends and allies in the greater cause.  We should not let differences in approach create divides but rather use this as an opportunity to have thoughtful dialogue and debate, and develop consensus around a Constitutional limited government solution that can be broadly embraced and truly take back power from the Federal Government in keeping with the intent of the Founders and the spirit of the Grassroots movement that brought us together in 2009.

For more information, please refer to the 10th Amendment Center website or contact your local 10th Amendment Center State Coordinator.

Jim Vetter [send him email] is the Outreach Director for the Pennsylvania Tenth Amendment Center.

Copyright © 2011 by Permission to reprint in whole or in part is gladly granted, provided full credit to the author and this website is given.

The 10th Amendment

“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”



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