Out of Control Policy Blog

Health-Care Reform Attacks Federalism

Federalism is one of the bedrock principles of American governance. I wonder how many Congressman really understood how the health-care reform plan passed by Congress on Sunday really was a direct challenge to Federalism.

Federalism is the governing principle by which the national government has certain rights and responsibilities and state governments have independent rights and responsibilities. The two governments are not subservient to the other; they act as independent governments and sovereign to themselves. They are also not "partners".

Federalism was so important, the Bill of Rights--a nonnegotiable set of Amendments added to the Constitution in order for it to be passed--included the 10th Amendement which says that any rights and duties not given to the Federal government in the U.S. Constitution are reserved for state government.

The health-care reform plan, according to the White House summary, undermines the core governing principle of Federalism in several ways, not the least of which is treating states as if they are, at best, junior partners with the Federal government, or, at worst, little more than wards of the Federal government. The health-care reform legislation will mandate that states provide certain levels of benefits to medicaid patients, force them to expand Medicad eligbility, require them to create and regulate insurance exchanges for low-income households, require them to "monitor and remediate high-risk billing activity" for prescription drugs, require state insurance "authorities to conduct annual rate reviews, backed by the oversight of the [U.S. Department of Health and Human Services] Secretary."

States already recieve 40 percent of their Medicaid funding from the federal government. So this reform is simply reinforcing a broader trend toward a unitary system of government, with the national government setting goals and objectives and lower levels of government carrying them out.

Unfortunately, this is really all part of a progressive vision to change the way America governs itself. The U.S. Constitution, by dividing power to protect liberty, is an antiquated governing system that gets in the way of doing what's right--like federalize health care. The priority of government is implementing goals hashed out in the national legislature.

Some states, most notably Viriginia, are taking this challenge head on. The state passed legislation prohibiting the federal government from mandating that Viriginia citizens buy health insurance. I hope they are successful, nothing less than the continued viability of American Federalism depends on it.

Samuel Staley is Research Fellow


« Dr. Obama's Idea of Change | Main | Video: Interview on What's Wrong… »




Out of Control Policy Archives