The Affordable Care Act (ACA) was a milestone in many ways, marking previously uncharted territory in federal arrogance and overreach. As health-insurance policy goes, it promises to prove catastrophic, but its constitutional implications are more worrisome still in that it is among the most insidious attempts yet to reduce the states to mere administrative subdivisions of the federal government. Led by Oklahoma, many states have pushed back by declining to comply with the law’s demand that states create health-insurance exchanges. We encourage those states to hold their ground, and we hope that others will join them.
Backers of Obamacare want state governments to create exchanges. They note that the federal government will step in and create the exchanges itself if states refuse to comply. Some state leaders, believing resistance to the law to be futile and seeking what control they can exercise over health policy in their states, are tempted to give in.