Lawmakers who insist the Graham-Cassidy bill enhances Federalism need a refresher course on civics.
An interesting component of the debate over healthcare reform is emerging from the right. It’s subtle, but it’s one that cannot be dismissed, for it contains an errant definition of the idea of federalism.
In an interview with FOX and Friends earlier this week, Vice President Mike Pence — who could turn out to be the tie-breaking vote in a very contentious Senate battle over the Graham-Cassidy healthcare bill — suggested that the proposal would restore the principles of federalism by allowing the states to make important decisions rather than the national government.
Pence made the assertion to disregard a question on preexisting conditions. When asked whether the bill would allow states to lift restrictions limiting insurance companies from charging people with previous ailments more in premiums, Pence said having the decision made at the local level simply made sense. “Who do you think will be more responsive to the healthcare needs in your community?” he answered rhetorically. “Your governor and your state legislator? Or a congressman and a president in a far off nation’s capital?”
Then, he added, “This is the concept of federalism.” (It’s also a great example of how to avoid questions you don’t want to answer honestly.)
Sen. Richard Shelby (R-AL) also defended his support for the bill on similar grounds. “Our states — our 50 states — are very flexible, very innovative,” he said. “I think it will work, and it will be a big step toward federalism.”
Paul Ryan made the same claim in a tweet he issued earlier in the week, explaining that he’d “take federalism over Obamacare any day.”
I appreciate Senators Graham and Cassidy continuing to work on a plan to pass the Senate. I’ll take federalism over Obamacare any day.
— Paul Ryan (@SpeakerRyan) September 15, 2017
These arguments (if you can call them that) rely on the premise of defending federalism. Yet, the bill they propose doesn’t actually do anything of the sort.
To refresh your mind back to your ninth grade civics class, federalism is the concept of two governments creating laws applicable to one geographic area. Oftentimes, one of those governments is superior to the other — its laws outweigh the mandates made by the other governing body.
Federal systems needn’t be one shape or form, either. They can include systems where many separate nations are involved, like the European Union and the countries that choose to enter into that particular pact. Or they can be similar to the United States model, where geographic areas (like states) adhere to laws passed by both local and national governments.
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Why do we have federalism? While debating what form the second government of the United States should take, the founding fathers rejected a unitary system of governance — they didn’t want the British model, which at the time involved the national government dictating the rules and laws for the entire nation.
But they had also seen how the opposite system of governance, a confederacy, had failed under the Articles of Confederation. The founders desired a system that blended the two: allowing local governments like states to pass laws applicable to the people in their borders, but also allowing the national government to pass laws applicable to the citizenry as a whole.
The Constitution has several rules for how the federalism in the U.S. should operate. The Supremacy Clause, found in Article VI, states that the laws and treaties passed by Congress and signed by the president are “the supreme law of the land.” Conversely, the 10th Amendment of the Constitution also states that any powers not reserved by the national government “are reserved to the states respectively, or to the people.”
In the spirit of that very brief history and civics lesson, does the Graham-Cassidy healthcare bill preserve or otherwise enhance federalism?
No, it doesn’t. We have a law on the books (Obamacare) that enacted a national program for healthcare. That law resides within the confines of federalism, from our definitional standpoint: it is a law that was passed by the national government, which means it supersedes state laws on the same aspects of healthcare. It by no means oversteps its place — it was passed under the rules of the Constitution, approved by both houses of Congress, signed by the president, and even withstood the scrutiny of a conservative Supreme Court.
Repealing that law won’t change anything about the federalist system of government we currently have. But it’s a nice sound byte, one that Republican lawmakers clearly practiced before touting their plan of raising healthcare costs on the American people, specifically those who have preexisting conditions.