The Obamacare Anti-Federalists

The federal government has too much control over the welfare state.

As Obamacare sputters along, liberals are growing increasingly frustrated that it isn’t working the way it was supposed to. First, the Supreme Court ruled that Medicaid expansion was optional, and then half the states opted not to expand. Even more states (36 so far) opted not to set up health-insurance exchanges and just let the feds do it themselves. Then last month the D.C. Circuit Court ruled that the law doesn’t allow subsidies to be disbursed through federal exchanges.

For many on the left, the culprits here are the intransigent states that refuse to go along with the Obamacare scheme. At a conceptual level, the real culprit is therefore federalism — the Constitution’s separation of state and federal powers. As Slate’s Jamelle Bouie lamented last week, states have “too much discretion in administering the welfare state.” He claims that some state leaders — like Mississippi governor Phil Bryant — don’t really even want to have safety-net programs and therefore can’t be trusted to run them. Programs like Medicaid, he says, should be taken out of the hands of the states and turned over entirely to bureaucrats in Washington.

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