Summary: No matter how the efforts to repeal and replace Obamacare turn out, I’m sorry to say that President Obama’s Affordable Care Act has federalized health care forever. It has changed the conversation so that, instead of debating whether the federal government should or constitutionally may take over health care, we are instead debating how. As political scientist James Q. Wilson pointed out, once Congress has entered a field of regulation, the legitimacy of federal action is established and is rarely debated again. Sadly, in the case of Obamacare, this was accomplished by a straight party-line vote of Democrats. Surprisingly, in that same time frame, the federalization of education policy was also accomplished, but is now turning back to the states. There was such an outcry over Common Core and federal testing that teachers and parents changed the law in Washington. Unfortunately that’s not likely to happen with an entitlement like healthcare, which has now—almost certainly—been federalized forever.
