State health care 'compact' advances; Some states wrestle with exchanges, MLR

States take a variety of steps regarding their roles in implementing the health law or trying to stop it.

The Hill: Health Care 'Compact' Advances In Two States
Oklahoma and Tennessee moved forward Wednesday on the health care "compact" that some states are pursuing as a challenge to the health care reform law. Oklahoma Gov. Mary Fallin (R) signed the multi-state compact Wednesday, and it passed the state Senate in Tennessee. Georgia Gov. Nathan Deal (R) is the only other governor to sign the agreement. It has been introduced in 14 states and passed by at least one chamber in nine statehouses (Baker, 5/18).

Politico Pro: Oklahoma Joins Health Care Compact
It was a good day for the conservative activists who are pushing the idea of a "health care compact" of states that are trying to band together to opt out of the federal health care overhaul. Oklahoma Gov. Mary Fallin, a Republican, signed the bill to join the compact on Wednesday. With that, Oklahoma joins Georgia, officially creating a two-state compact that conservatives hope can eventually stop the health care overhaul. Also on Wednesday, the Tennessee Senate passed legislation to join the compact. If enough states pass the compacts and Congress grants approval, the compacts would give the states control of all health care except for veterans' coverage (Haberkorn, 5/18).

CQ HealthBeat: State Legislators Tussle Over Health Benefit Exchanges As Adjournments Near
As state legislatures near the end of their sessions, many lawmakers are still struggling with whether to approve measures to set up health-benefits exchanges created under the health care law — and it appears almost certain work in many states will extend into 2012. While a few states have enacted legislation and others may be nearing final action, many others are torn by differing opinions among politicians, health care providers and consumers about what an exchange should look like or how it should function (Norman, 5/18).

Modern Healthcare: Del., Ind. Seek Relief On Medical-Loss Ratio
Indiana and Delaware are the latest states seeking relief from a provision of the federal health reform law requiring that insurers spend 80 cents of every individual premium dollar on direct medical care and quality efforts starting this year. Insurers that don't meet this threshold must rebate the difference to individual policyholders starting next year (Vesely, 5/18).