Are we all health care federalists now? No more so than when we once were “all Keynesians now,” in the words of President Richard Nixon, and Milton Friedman, over 40 years ago.
Nevertheless, leading members of both political parties have tried to duck under their leaky umbrellas of rhetorical federalism when facing the monsoon of challenges posed by Obamacare.
Republican presidential candidates and congressional leaders typically say they would delegate most health policy matters to the states. This reinforces their embrace of older constitutional limits on the powers of the national government. It also provides a buffer against the centralizing power grabs of their nanny-state adversaries. Fifty different states can experiment in health policy without blowing up the entire national laboratory.