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The Supreme Court's recent decisions in United States v. Lopez1 and United States v. Morrisonl articulate a vision of federalism which severely limits Congress' regulatory authority under the Commerce Clause in favor of state or local control of traditional areas of state concern. The Court's decisions coincide with ballot initiatives that show the states still desire to maintain control over many aspects of healthcare; medicinal marijuana, physician-assisted suicide, and embryonic stem cell research are a few prominent examples. While some of these issues face challenges under federal law, Congress' authority tO regulate intrastate activities based on a tenuous connection to commerce is no longer a foregone conclusion. Still, the spending power of the federal government is nearly limitless, allowing it to influence or control state government regulation of health care. A national health care system will stifle the states' ability to experiment with health care issues and reform. Ultimately, the states' ability to function as laboratories of democracy in search of solutions or in experiniental areas that lack a national consensus will be lost if a national health care plan is implemented without imposing limitations on the broad congressional spending power.

State Innovation in Health Care: Congress' Broad Spending Power Under a National Health Care System will Stifle State Laboratories of Democracy