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The notwithstanding clause of Canada’s Charter of Fundamental Rights and Freedoms is one of the more peculiar tools of federalism.  It doesn’t really exist as a matter of law in the States. The charter is roughly the same as our Bill of Rights. Up north, the individual provinces can opt out (or in) to certain constitutional provisions. Complicated?!? You betcha. What’s more complicated is that members of Congress are considering granting the individual state’s permission to do the same thing in the pending Healthcare Reform bill. (S.703/Sanders [VT] and H.1200/McDermott [WA])

Born of compromise, Congressional leaders are considering provisions in both the House and Senate bills that would allow individual states to offer a public option, or go and mandate a single payer system. This scheme would allow Montana to adopt a single payer while Nebraska and Wyoming would not necessarily have such an option because their individual state legislatures had not chosen to pursue such an option.

What does this mean? Well, if enacted (and we are a long way from having any bill enacted, or implemented) the state’s would once and for all be the party responsible for managing day to day health policy issues ranging from access to care thru funding. It also means what state you call home may have a great deal to do with how good a level of care one might expect to receive.

As development evolve in Statehouses and Capitol Hill, HFA’s public policy team is committed to providing the community with the soundest information available. Questions, comments…. Feel free to reach out to Kisa and Steve with your concerns online or by phone at the HFA offices.

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