Health Care Plan: Back Door Federalism?

Usually we think of federalism as the national government stepping back and letting states lead the way. Innovation happens in the 50 laboratories of democracy, eventually the best ideas bubble to the top, and the states flock to the model that works. The assumption is that the division of powers is uniform: if, hypothetically, the federal government abnegated its role in public education, all 50 states would assume responsibility for it.

But the latest version of the so-called public option for health care seems to turn federalism on its head: the national government will roll out its own health insurance plan and the states can choose not to participate. The Heritage Foundation, for one, does not think it will work.


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