Health Care Compact Shifts Power from Feds to States

Innovative approach to governance gives Americans more influence over health care law  
Alexandria, VA– The Health Care Compact Alliance today unveiled the Health Care Compact, an agreement between participating states that restores authority and responsibility for health care regulation to member states. The compact seeks to engage citizens in the development of state-based health care reform.

“The Health Care Compact is a governance reform, not a health care reform,” said Eric O’Keefe, Chairman of the Health Care Compact Alliance. “Most Americans are frustrated by our health care system’s flaws and dismayed about the number of people the system fails. We have not been thinking creatively enough about the issue because too many of us assume that important public policy issues must be decided at the highest level, when just the opposite is true. An issue as personal as health care should be decided as close to home as possible.”

Citizens generally enjoy greater access to their state lawmakers than they do to their representatives in Congress. Shifting responsibility for health care regulations to state lawmakers, the Health Care Compact makes it possible for Americans to exercise greater control over their health care. The way health care works in a member state is not prescribed in the compact, a simple document that adjusts where the decisions are made. Who and what is covered as well as the level of regulation is determined by each state after the compact is ratified.

Compacts, dating back to the Mayflower Compact of 1620, have been used to innovate reforms throughout U.S. history. Authority for compacts was established in the Constitution (Article 1, Section 10), and more than 200 such agreements have been developed. These are voluntary agreements between citizens, groups of citizens acting as states, and groups of states. When consented by congress, they have the force of federal law.

O’Keefe added, “We look forward to the imaginative ideas that will be put forward by Americans and their state legislators, and are delighted to bring forward this tool to support citizen-based governance and health care reform.”

About the Health Care Compact Alliance

The Health Care Compact Alliance is a nonpartisan [501 (c)4] organization providing tools that enable citizens to exert greater control over their government. The Health Care Compact was developed to offer Americans more influence over decisions that govern health care. For more information, please visit