The American Spectator : Health Care Overhaul Threatens States

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Health Care Overhaul Threatens States

By Philip Klein on 7.14.09 @ 6:09AM

The Democrats’ proposed health care overhaul raises federalism concerns and burdens cash-strapped states with hundreds of billions of dollars in new spending obligations.

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Michael Greve, an American Enterprise Institute scholar who focuses on federalism, said that any state that accepts Medicaid money would have to go along with any conditions the federal government attaches to it. “The central problem is the temptation by the states,” he said.

However, he said that the imposition of health insurance exchanges on the states raises much more complex legal issues involving the hotly contested concept of “conditional preemption,” which is when the federal government tells states to enact a given regulation or else have the federal government do it for them. Greve said his hunch is that the current U.S. Supreme Court would find such a provision unconstitutional.

As legislation moves through Congress, at least one state is trying to protect its citizens against federal overreach. Last month, the Arizona state legislature voted to include a referendum on the 2010 ballot that would amend the state constitution to prevent anybody in the state from being forced to participate in any health care system. Practically speaking, the provision would mean that people and businesses in Arizona would be exempt from insurance coverage mandates.

“This is an effort to create a federalism shield to protect the rights of Arizonans,” said Clint Bolick, a director at the Phoenix-based Goldwater Institute, who supports the measure.

In 2008, Arizona voters narrowly rejected a similar proposal by less than 9,000 votes out of more than 2.1 million cast after then Gov. Janet Napolitano campaigned vigorously against it. But Bolick said that the 2010 proposition has different language that prevents opponents from arguing that it would affect existing state programs.

The legislation would not seek to address the issue created by the imposition of an insurance exchange on the state, but Bolick said such a provision could be challenged under the “anti-commandeering” principle. This applies when “the federal government enlists the state as if it were an agent of the federal government,” he said. “That raises constitutional alarm bells.”

Christie Herrera of the American Legislative Exchange Council, which boasts 1,800 conservative state legislators as members, said that efforts are already underway in five other states (Indiana, Minnesota, New Mexico, North Dakota, and Wyoming) to imitate the Arizona example if it succeeds next year.

Health care has already been the subject of several failed state experiments. In 1994, Tennessee expanded Medicaid coverage, but by 2003 its health care system was deemed “not financially viable” and Democratic Gov. Phil Bredesen was forced to rein in the program.

In 2006, then-Massachusetts Gov. Mitt Romney signed health care legislation in which the state government forced individuals to obtain coverage and offered them subsidies to purchase government-designed plans on a government-run exchange. The result has been skyrocketing costs and longer waits in doctors’ offices. A Rasmussen poll taken last month found that just 26 percent of voters in the overwhelmingly liberal state said the effort was a success.

Instead of learning from these failed experiments, Democrats in Washington are planning to use federal power to muscle all states into replicating them.

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topics:
Health Care, Medicaid, Federalism

About the Author

Philip Klein is The American Spectator's Washington correspondent. You can follow him on Twitter at: http://twitter.com/Philipaklein

Letter to the Editor View all comments (16) | Leave a comment

Hank Rearden| 7.14.09 @ 8:03AM

Good article. I'm glad you mentioned Kennedy. Why anyone would take any of the legislation he wrote seriously is beyond me seeing as his biggest success in life was not being convicted of vehicular manslaughter. Remember, this is the same genius that Bush had author No Child Left Behind, a grand piece of legislation that is yet another unfunded mandate.

cary loos| 7.14.09 @ 11:23AM

Thank you for raising the "Federalism question."
I don't know what it will take to wake Americans up to this danger. Incombent protected sultans
will imposing their will where no contravening authority exists in opposition. We have witnessed this phenonenon in action since the "Great Society" programs of the sixties and it has only accelerated in the last six months. Let freedom ring and grant the States the stones to exercise their push back responsibility.

Lu Dumak| 7.14.09 @ 11:25AM

Our Representatives should be using the 10th and 14th amendment to fight this farce of Goverment health care. We should start by putting Kennedy on the health care he wants for the American people.

Death is Americas salvation| 7.14.09 @ 5:06PM

Health care for all is a must, because you are not incontrol of your own destiny. The State decides if you live or die, and many will be euthanased, no longer productive, serves no purpose you have a destiny with death.

No more private insurance put public health to control who lives and who dies.

The planet is over populated, and must be reduced to under 3 Billion people, that is the Zionist policy. Nothing you can do about it Americans does not control America it's controled by Zionist.

All people who whish to be elected has to be confirmed by Zionist and swear an allegiance to APIAC and Israel.

America is the only country on earth that has to do that swear allegiance to a foreign body.

Brittanicus| 7.14.09 @ 6:39PM

MEDICAL CARE SHOULD BE THE CHOICE OF EACH AMERICAN

The deciding factor in implementing health care for everybody--LEGALLY--in America, is the Publics voice? Those who want to just follow the same old road, can do so with the profit taking commercial insurance. Those who would be satisfied with a government run health care program, can now start demanding it from the lawmakers. Those who see a Universal health care system, similar to most developed countries in Europe, should start informing every Representative and Senate politician starting today. Rationing in places like England, was caused by the major impact of uncontrolled immigration.

Most American working class can do--without-- high premiums, pre-existing condition clauses. deductibles, co-pays that is representative of the wealthy medical care insurers. Whatever pertains to your family, you should start ruffling the indifferent feathers of the people in Washington at 202-224-3121 Just like illegal immigration , we cannot afford anymore to subsidize the business that hire them or the millions of illegal families.

Alan Brooks| 7.14.09 @ 7:13PM

NO POINT IN TRYING, THE TROLLS WILL DROWN YOU AT THIS BLOG.
we are just going through the motions now. game over

Alan Brooks| 7.14.09 @ 7:20PM

btw, AS is relative sanity in this misfired 21st century, but the cover photo of the guy-- even if he is a doctor-- holding a naked boy is okay but perhaps slightly unwise in the Age of Jacksonian democracy. we have to be nobler than Caesar's wife; this isn't the '80s; now we have to walk on eggs!

Alan Brooks| 7.14.09 @ 7:20PM

Alan Brooks| 7.14.09 @ 7:54PM

why am I upset about the trolls? look at the "America Will Die" posts. who does Daphne work for, anyway? Al Jazeera?

Finrir| 7.15.09 @ 12:53AM

Here I am, a 15 year old, concerned about this topic. Of cource people my age and younger should be concerned. The debt that this bill will put on our contry will leave me, my children, my grandchildren, and maybe even my great grandchildren left to pay it off. We will all be broke. I urge everyone old enough to urge their senators and representatives to vote NO on this bill, or you could consider this country destroyed. I for one, will move to either Canada or England later in life should this retardedness pass. It is simply a taxation overhaul.

Danny Jackson| 7.15.09 @ 2:29AM

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jordan 6 rings| 7.17.09 @ 4:52AM

Good article. I'm glad you mentioned Kennedy.

Richard Baker| 7.22.09 @ 4:38PM

Death is Americas salvation:
Are you volunteering to be one of the subjects of the population reduction you say must happen? May I be of assistance in your personal reduction?

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Karl Lazar| 10.26.10 @ 3:12PM

As any expert will tell you, if you want to make sure everybody has at least basic insurance, at a reasonable price, and you want to do it primarily through private coverage, the individual mandate is essential. So unless you oppose the mandate from the left--that is, you prefer people get coverage from some kind of public insurance--to oppose the mandate is to oppose the idea that people with high medical risks deserve access to the best health insurance, at the same price, as people who are healthy. I know that's how a lot of conservatives feel. But that's now become a litmus test for the party's nomination? Whatever happened to compassionate conservatism?