Unless the Constitution of the United States specifically addresses a given power of the Congress, then any additional responsibilities fall to the legislative powers of the individual states. That is the reasoning behind the idea that the health care reform bill passed by the Congress is unconstitutional and subsequently illegal.
Many states require drivers to purchase automobile liability insurance, whether they want it or not, for the good of all. While some people are concerned with that level of government control, there is no serious discussion of moving to Costa Rica in protest of the law. The acceptance is based on the individual state’s constitutional rights to pass that type of legislation. This state’s rights philosophy drives the very public outcry that the federal government should be sued for requiring that all citizens purchase health care insurance.
Years of constitutional interpretations will ultimately decide the legality of the health care reform legislation. However when states pass individual laws which impact all Americans, the power base becomes complicated.
When South Dakota voted to remove its usury laws which cap interest rates, Citibank moved its headquarters (and many good jobs) to South Dakota so they could charge higher interest rates on all credit cards issued throughout the entire country. Delaware followed a similar path and removed its usury laws and became the headquarters for other banks. These two states passed state legislation that negatively impacted the other 48 states.
In 1994, Tennessee enacted state-wide health care reform using managed care, federal funds, and increased competition among insurance providers (sound familiar?). This radically improved Medicaid system was known as TennCare. By 1995, enrollment reached 1.2 million as people flocked to the state in order to take advantage of the health care opportunities afforded by the reform. In part, the actions of citizens from other states left Tennessee with a health care system that was economically unsustainable. Any health care reform at the state level is going to be impacted by people moving into or out of an area based on the quality, accessibility, and affordability of health care.
Many believe that in a capitalist society that the market should be self-governing. Based on the economic realities which are a product of years of de-regulation, the argument is difficult to sustain. Many believe that state’s rights supersede federal intervention. This argument is equally difficult to sustain when faced with state laws that frequently impact the other 49.
Why would we expect economic improvements if we are unwilling to do things any differently? We cannot know the long term implications of any reform, but fear of change and the apparent love of hate are leaving Americans stymied and unable to move forward. A liberal believes you should be open-minded enough to adjust to changed circumstances. Sounds like a good quality to me!