Will States' Rights Go the Way of Medicaid Funding?

As the Senate debates the Trump administration's "One Big Beautiful Bill," a hypocrisy at the heart of the debate is getting little attention. If the bill stays similar to what passed the House, the federal government will coerce states into restricting access to Medicaid, on which over 72 million peopleopens in a new tab or window rely for health insurance.

Though hypocrisy is hardly a new feature of American politics, this is a notable departure from frequent conservative arguments that many facets of public policy ought to be left to the states, which can respond to more local preferences and needs. This regulatory philosophy has driven arguments across a range of policies including abortion leading up to the fall of Roe v. Wade, Medicaid expansion, marijuana decriminalization, and the rights of same-sex couples prior to Obergefell v. Hodges. Now, conservatives seem set to abandon this principle for one of the nation's biggest public policy programs.