Federalism has often been called the “oldest question of American constitutional law.”1 To this day, it has remained the basso continuo of the country’s politics. The protracted litigation over the 2010 Affordable Care Act suggests a distinctive, recurrent pattern. Like almost every major engagement over domestic policy in U.S. history, the fight over universal health insurance came to revolve around federalism—the powers of Congress to regulate, to tax, and to bargain with states. And, inevitably, the controversy ended up in the Supreme Court. NFIB v. Sebelius...
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