- The Washington Times - Wednesday, January 17, 2007

Can states tackle a national problem that has stymied federal officials in Washington for years? Maybe, but there is an ironic twist when it comes to providing health coverage for more Americans. With respect to the uninsured, some believe the odds of state success may increase with a little help from the federal government. It’s an idea worthy of experimentation. And that’s exactly what a bipartisan group of senators and congressmen intend to do by introducing the Health Partnership Through Creative Federalism Act.

Yesterday, Democrat Sen. Jeff Bingaman of New Mexico and Republican Sen. George Voinovich of Ohio, along with Democratic Reps. Tammy Baldwin of Wisconsin and John Tierney of Massachusetts, and Republican Rep. Tom Price of Georgia introduced bipartisan legislation encouraging states to develop creative methods to cover the more than 45 million uninsured Americans. The measure potentially unleashes dozens of new local and regional-level approaches to address the issue of the uninsured, and it would test the efficacy of these new programs using states, to borrow a phrase from former Supreme Court Justice Louis Brandeis, as “laboratories of democracy.” It encourages local officials to tailor health care reform programs to their own populations and needs, allowing policy-makers to evaluate which approaches work best, which fail, and why.

The legislation is significant for what it could do to help cover the uninsured, but also because it captures the new breezes blowing over Washington’s policy and political landscape.

For those closely watching policy-making in Washington over the past decade, it represents a welcome return to principles of new federalism. Following the 1994 election Republicans talked a lot about devolving power to the states. Yet that rhetoric and the policies to back it up waned — in many ways to the GOP’s detriment. As Republicans consolidated power in Washington by reelecting majorities for five congressional cycles since 1994 — and then capturing the presidency in 2000 and 2004 — using new federalism as a strategic and integral part of the GOP platform stalled in word and deed. Republicans traditionally criticized Democrats for believing only Washington held the prescriptions to cure our domestic policy ills. For the past decade Republicans became infected with this same inside-the-beltway disease.

Governors have been the political equivalent of Nobel Laureates in these laboratories of democracy, boldly experimenting with new ideas. Mitt Romney of Massachusetts has enacted a plan for his state and Gov. Arnold Schwarzenegger recently proposed a new program to broaden coverage for the uninsured in California as well. Other states are following suit, frustrated by years of gridlock in Congress. Experts may disagree with the substance, but the plans signal a growing demand for some type of action by policy-makers. Moreover, the other element these plans and other state initiatives have in common is a rejection of a “one size fits all” philosophy mandated by Washington. “States are frustrated with the lack of action and flexibility coming out of Washington,” Mr. Price of Georgia told me last week. “Creative federalism allows states to craft solutions that fit their particular needs best.” Mr. Bingaman agreed, saying yesterday, “There is no single prescription to solving our nation’s serious uninsured problem. Extending health care to the millions of Americans who are uninsured will require the innovation of governors and other leaders in all 50 states.”

Finally, the authors of the legislation recognize an important old axiom that applies well in the new Washington environment: Legislation with bicameral and bipartisan support has the greatest chance of passing. As I wrote last week, Americans rarely remember the score of sporting events at half time. Similarly, they don’t give lawmakers credit for muscling legislation through one house, only to see it die in the other — that’s only half of the process. Introducing a bill that has bipartisan, bicameral support maximizes the chances that this bill will eventually cross the goal line, not just make a partisan statement.

After a political season characterized by Democrats running more “against” Republican failures than “for” a positive agenda, and the GOP clinging tightly to accumulated power, rather than offering new ideas, the Health Partnership Act is a refreshing reservoir in an arid landscape. And while conservatives may not like every solution proposed by states, devolving power, influence, and decision making out of Washington is a principle that deserves rekindling. Ironically, it’s Washington policy-makers and legislation like the Health Partnership Act that could ignite these fires of flexible federalism again.

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