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date: 01 October 2020

Abstract and Keywords

This chapter examines the role of political and constitutional federalism in the piecemeal evolution of U.S. healthcare law. It begins by charting the rise and fall and rise again of constitutional federalism in the United States, from its early history to the Civil War period, the Lochner Era of Supreme Court jurisprudence, the New Deal revolution of 1937, and through the “New Federalism” movement of the 1970s and 1980s. It then considers healthcare regulation during the Progressive Era and political opposition to national healthcare regulation. It also discusses the rise of employer-sponsored health insurance as an element of employee compensation, Medicare and Medicaid, the Employee Retirement Income Security Act of 1974 (ERISA), and the Patient Protection and Affordable Care Act (Obamacare). Finally, it analyzes two important aspects of Obamacare that fell prey to the Supreme Court’s revival of constitutional federalism and concludes by speculating on the future of healthcare federalism.

Keywords: constitutional federalism, healthcare law, Supreme Court, New Federalism, healthcare regulation, Medicare, Medicaid, Employee Retirement Income Security Act of 1974, Patient Protection and Affordable Care Act, healthcare federalism

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