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Federalism and the End of Obamacare Print E-mail
Written by Nicholas Bagley | The Yale Law Journal   
Thursday, 16 February 2017 00:00

Federalism has become a watchword in the acrimonious debate over a possible replacement for the Affordable Care Act (ACA). Missing from that debate, however, is a theoretically grounded and empirically informed understanding of how best to allocate power between the federal government and the states. For health reform, the conventional arguments in favor of a national solution have little resonance: federal intervention will not avoid a race to the bottom, prevent externalities, or protect minority groups from state discrimination. Instead, federal action is necessary to overcome the states' fiscal limitations: their inability to deficit-spend and the constraints that federal law places on their taxing authority. A more refined understanding of the functional justifications for federal action enables a crisp evaluation of the ACA-and of replacements that claim to return authority to the states.

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Last Updated on Friday, 17 February 2017 19:11

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