Rhetorical Federalism: The Value of State-Based Dissent to Federal Health Reform

58 Pages Posted: 24 Aug 2010 Last revised: 2 Oct 2015

See all articles by Elizabeth Weeks

Elizabeth Weeks

University of Georgia School of Law

Multiple version iconThere are 2 versions of this paper

Date Written: August 23, 2010


This Article makes the affirmative case for the widespread trend of state resistance to the recently enacted, comprehensive federal health reform law, the Patient Protection and Affordable Care Act of 2010, or ACA. A significant number of states have engaged in various forms of objection to the new federal laws, including filing lawsuits against the federal government, enacting laws providing that ACA will not apply to residents of the state, and refusing to cooperate with implementing the new laws. This Article identifies reasons why those actions should not be disregarded simply as Tea Party antics or election-year gamesmanship but instead should be considered valuable to health care policymaking and federal-state relations. In making the case for rhetorical federalism, the Article examines and expands previously articulated theories, including uncooperative federalism and opportunistic federalism. Key provisions of ACA implicating states are examined under the operative theories.

Keywords: Health law, health reform, federalism

JEL Classification: D70, D80, H11, H40, H51, H77, I11, I18, I38, K32, L51, G22

Suggested Citation

Leonard, Elizabeth, Rhetorical Federalism: The Value of State-Based Dissent to Federal Health Reform (August 23, 2010). Hofstra Law Review, Vol. 39, p. 111, 2011, Available at SSRN: https://ssrn.com/abstract=1663947 or http://dx.doi.org/10.2139/ssrn.1663947

Elizabeth Leonard (Contact Author)

University of Georgia School of Law ( email )

225 Herty Drive
Athens, GA 30602
United States

HOME PAGE: http://www.law.uga.edu/profile/elizabeth-weeks-leonard

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