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Rhetorical Federalism: The Role of State Resistance in Health Care Decision-Making

Published online by Cambridge University Press:  01 January 2021

Elizabeth Weeks Leonard
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Extract

The Patient Protection and Affordable Care Act (ACA) represents the most significant reform of the United States health care system in decades. ACA also substantially amplifies the federal role in health care regulation. Among other provisions, ACA expands government health care programs, imposes detailed federal standards for commercial health insurance policies, creates national requirements on employers and individuals, and enlists state administrative capacity to implement various federal reforms. In response, a persistent voice in the protracted, contentious debate surrounding ACA was, and continues to be, resistance from states. The rhetoric of federalism — states’ rights, reserved powers, state sovereignty, limited government, and local diversity — resonates deeply even around provisions of ACA that do not specifically implicate state interests. For example, the loudest and most persistent state objections target the new mandate that individuals maintain health insurance, a requirement imposed by ACA and enforced through federal tax penalties.

Type
JLME Supplement
Information
Journal of Law, Medicine & Ethics , Volume 39 , Issue S1 , Spring 2011 , pp. 73 - 76
Copyright
Copyright © American Society of Law, Medicine and Ethics 2011

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References

Pub. L. No. 111–148, 124 Stat. 119 (2010) (signed March 23, 2010), available at <http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf> (last visited December 10, 2010), amended by Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111–152 (2010)), available at <http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h4872enr.txt.pdf> (last visited December 10, 2010).+(last+visited+December+10,+2010),+amended+by+Health+Care+and+Education+Reconciliation+Act+of+2010,+Pub.+L.+No.+111–152+(2010)),+available+at++(last+visited+December+10,+2010).>Google Scholar
This article is an abbreviated version of a longer, forthcoming article, Leonard, E. W., “Notes from the Tea Party: The Affirmative Case for the Health Reform Nullification Movement,” Hofstra Law Review 39 (2011), draft available at <http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1663947> (last visited December 10, 2010).Google Scholar
See Cauchi, R., National Conference of State Legislatures, State Legislation Opposing Certain Health Reforms, 2010, available at <http://www.ncsl.org/default.aspx?tabid=18906> (last visited December 10, 2010) [hereinafter cited as NCSL].+(last+visited+December+10,+2010)+[hereinafter+cited+as+NCSL].>Google Scholar
Tenth Amendment Center, The Tenth Amendment Movement, available at <http://www.tenthamendmentcenter.com/the-10th-amendment-movement/#resolutions> and <http://www.tenthamendmentcenter.com/the-10th-amendment-movement/#10thbills> (both sites last visited December 10, 2010).+and++(both+sites+last+visited+December+10,+2010).>Google Scholar
Complaint, State of Florida v. Sebelius (N.D. Fla., March 23, 2010) [hereinafter Florida Complaint], available at <http://myfloridalegal.com/webfiles.nsf/WF/MRAY-83TKWB/$file/HealthCareReformLawsuit.pdf> (last visited December 10, 2010); Complaint for Declaratory and Injunctive Relief, Virginia v. Sebelius, Civil Action No. 3:10CV188 (E.D. Va. March 23, 2010) [hereinafter Virginia Complaint], available at <http://www.oag.state.va.us/PRESS_RELEASES/Cuccinelli/Comm%20v.%20Sebelius%20-%20Complaint%20filed%20with%20Court%20_323_10.pdf> (last visited December 10, 2010).+(last+visited+December+10,+2010);+Complaint+for+Declaratory+and+Injunctive+Relief,+Virginia+v.+Sebelius,+Civil+Action+No.+3:10CV188+(E.D.+Va.+March+23,+2010)+[hereinafter+Virginia+Complaint],+available+at++(last+visited+December+10,+2010).>Google Scholar
Virginia Code § 38.2–3430.1:1.Google Scholar
Virginia ex rel. Cuccinelli v. Sebelius, 702 F.Supp.2d 598 (E.D.Va.,2010); Florida ex rel. McCollum v. U.S. Dept. of Health & Human,__F.Supp.2d __, 2010 WL 4010119 (N.D.Fla., 2010).Google Scholar
See Commonwealth ex. rel. Cuccinelli v. Sebelius, _F.Supp.2d_, 2010 WL 5059718 (E.D. Va 2010) (memorandum opinion on cross-motions for summary judgment.)Google Scholar
See Brown, R., “Georgia Insurance Commissioner Balks at Request on New Health Law,” New York Times, April 13, 2010, available at <http://www.nytimes.com/2010/04/14/health/policy/14georgia.html> (last visited December 10, 2010).+(last+visited+December+10,+2010).>Google Scholar
See Jennings, C. C. and Hayes, K. J., “Health Insurance Reform and the Tensions of Federalism,” New England Journal of Medicine 362 (June 17, 2010): 2244–2246, at 2245.CrossRefGoogle Scholar
See, e.g., Balkin, J. M., “The Constitutionality of the Individual Mandate for Health Insurance,” New England Journal of Medicine 362 (February 11, 2010): 482–483, at 482; Hall, M. A., “The Constitutionality of Mandates to Purchase Health Insurance,” Journal of Law, Medicine & Ethics 37 (2009): 38–50, at 40; Huq, A., “Bad Law, Smart Politics in Constitutional Challenges to Healthcare Reform,” The Nation, April 15, 2010, available at <http://www.thenation.com/article/bad-law-smart-politics-constitutional-challenges-healthcare-reform> (last visited December 10, 2010); Rosenbaum, S., “A ‘Customary and Necessary’ Program - Medicaid and Health Reform,” New England Journal of Medicine 362 (May 27, 2010): 1252–1255, at 1954.CrossRefGoogle Scholar
See, e.g., Jost, T. S., “Can the States Nullify Health Care Reform?” New England Journal of Medicine 362 (February 11, 2010): 869–871, at 869.CrossRefGoogle Scholar
See Cross, F. B., “Realism about Federalism,” New York University Law Review 74 (1999): 1304–1355, at 1306–1307 and n.10; Young, E. A., “Welcome to the Dark Side: Liberals Rediscover Federalism in the Wake of the War on Terror,” Brooklyn Law Review 69 (2004): 1277–1311, at 1283.Google Scholar
Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act of 2001, Pub. L. No. 107–56, 115 Stat. 272 (2001); see Althouse, A., “The Vigor of Anti-Commandeering Doctrine in Times of Terror,” Brooklyn Law Review 69 (2004): 1231–1275, at 1253–1257; Young, , supra note 14, at 1278, 1283.Google Scholar
See, e.g., Sunstein, C. R., Why Societies Need Dissent (Cambridge: Harvard University Press, 2003), at 145; Friedman, B., “Valuing Federalism,” Minnesota Law Review 82 (1997): 317–412, at 403; Gerken, H. K., “Dissenting by Deciding,” Stanford Law Review 57 (2005): 1745–1805; Porterfield, M. C., “State and Local Foreign Policy Initiatives and Free Speech: The First Amendment as an Instrument of Federalism,” Stanford Journal of International Law 33 (1999): 1–48.Google Scholar
See Rossiter, C., ed., The Federalist No. 70 (Alexander Hamilton) (New York: New American Library, 1961): at 426–437.Google Scholar
See U.S. Const, art. 1, § 8, cl. 1, 3; Gonzaga v. Doe, 536 U.S. 280 (2002) (recognizing Medicaid as spending power legislation); Atkins v. Rivera, 477 U.S. 154,156–157 (1986) (describing Medicaid legislation); Helvering v. Davis, 301 U.S. 619 (1937) (recognizing Social Security Act as valid exercise of spending power); Chapman, C. B. and Talmadge, J. M., “Historical and Political Background of Federal Health Care Legislation,” Law & Contemporary Problems 35 (1970): 334–347, at 336, 342; Rich, R. F. and White, W. D., “Federalism and Health Care Policy,” University of Illinois Law Review 1998 (1998): 861–884, at 872.CrossRefGoogle Scholar
See United States v. Lopez, 514 U.S. 549, 564 (1995) (“In addition to criminal law enforcement and education, health care regulation is an area where states historically have been sovereign.”); Jacobson v. Massachusetts, 197 U.S. 11, 24–25 (1905) (recognizing “the authority of a State to enact quarantine laws and ‘health laws of every description’”).Google Scholar
Two notable exceptions include the Employee Retirement Income Security Act of 1974 (ERISA), Pub. L. No. 93–406, 88 Stat. 829 (1974), codified as 29 U.S.C. §§ 1001–1461, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Pub. L. No. 104–191, 110 Stat. 1936 (1996).Google Scholar
See McCarran-Ferguson Act, 15 U.S.C. §§ 1011–1015.Google Scholar
See Kaiser Family Foundation, Kaiser Health Tracking Poll, May 2010, available at <http://www.kff.org/kaiserpolls/8075.cfm> (showing decreased confusion from April to May 2010, two months after enactment) (last visited December 10, 2010); Kaiser Health Tracking Poll, July 2010, available at <http://www.kff.org/kaiserpolls/upload/8082-F.pdf> (tracking senior's awareness of health reform components) (last visited December 10, 2010).+(showing+decreased+confusion+from+April+to+May+2010,+two+months+after+enactment)+(last+visited+December+10,+2010);+Kaiser+Health+Tracking+Poll,+July+2010,+available+at++(tracking+senior's+awareness+of+health+reform+components)+(last+visited+December+10,+2010).>Google Scholar
See Kaiser Health Tracking Poll, January 2010; Trapp, D., “Health Reform Provisions Poll Well Even If Bills Do Not,” American Medical News, March 22, 2010, available at <http://www.ama-assn.org/amednews/2010/03/22/gvsb0322.htm> (last visited December 10, 2010); “The Polling Contradiction,” Newsweek, February 19, 2010, available at <http://www.newsweek.com/2010/02/18/the-polling-contradiction.html> (last visited December 10, 2010).+(last+visited+December+10,+2010);+“The+Polling+Contradiction,”+Newsweek,+February+19,+2010,+available+at++(last+visited+December+10,+2010).>Google Scholar
See Kaiser Health Tracking Poll, April 2010 (revealing better public understanding of and stronger support for ACA provisions taking effect in first year after enactment), available at <http://www.kff.org/kaiserpolls/upload/8067-F.pdf> (last visited December 10, 2010).+(last+visited+December+10,+2010).>Google Scholar
See Weschler, H., “The Political Safeguards of Federalism: The Role of States in Composition and the Selection of National Government,” Columbia Law Review 54 (1954): 543–560, at 558.Google Scholar
See, e.g., A Pledge to America: The 2010 Republican Agenda, at 25–29, issued on September 23, 2010, the six-month anniversary of ACA's enactment, available at <http://pledge.gop.gov/resources/library/documents/solutions/a-pledge-to-america.pdf> (last visited December 10, 2010). (last visited December 10, 2010).' href=https://scholar.google.com/scholar?q=See,+e.g.,+A+Pledge+to+America:+The+2010+Republican+Agenda,+at+25–29,+issued+on+September+23,+2010,+the+six-month+anniversary+of+ACA's+enactment,+available+at++(last+visited+December+10,+2010).>Google Scholar