Stateline, May 3, 2011

Governors who oppose the national healthcare act have no shortage of strategies they are willing to try?federal lawsuits aimed at overturning it, state statutes barring its implementation, an attempt at congressional repeal. But another way around the controversial law may be emerging that, while it sounds far-fetched, theoretically could trump all others: a so-called interstate healthcare compact that would invoke a little-known clause in the U.S. Constitution. Here's how it would work: At least two states would agree to sign a joint agreement taking full responsibility for all health care policy within their borders. If the agreement is approved by Congress, the states that sign up would be given a block grant equal to the total of their federal healthcare funding for the prior year, including Medicare and Medicaid, with no strings attached. Other states could join later. The states would then work together or separately to develop homegrown health care policies that they believe meet their residents' needs.

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