As Senator Orrin Hatch (R-UT) said at an event on health care reform yesterday at the Heritage Foundation, “There is no such thing as a free lunch—especially if Washington is the one having you over.” Democrats continue to insist that the best way to reform the health care system is to centralize decision making and regulation within the federal government. Not only is this inaccurate, but it also goes against the same principles supported by the Constitution that House Speaker Nancy Pelosi flippantly dismissed at a recent press conference.

Health care is too complex and intricate to micromanage at the federal level. The best, and most constitutional, way to enact reform would be to set the framework for change at the federal level and then allow decision-making and implementation to be determined by the states. This is in accordance with the federalism employed by the founding fathers in molding our nation into a democratic republic. The founders recognized the limits inherent in political power, thus specifically limited the power given to the federal government by the Constitution. As former Congressman Thomas Feeney writes in a recent paper:

The national government, under the Constitution, is responsible for the general concerns of the republic; the state governments are the custodians of the people’s trusts and are authorized to address their particular concerns. This is the essence of federalism.

An example of federalism at its best is the health care reform currently being implemented in Utah. Utah is launching a new health exchange operated by just two state officials, adding little to no cost to the taxpayer. The exchange is accompanied by a defined-contribution system, which allows employers to make contributions to their employers’ choice of one out of 66 plans in the exchange. Couples can combine their employers’ contributions, and since plans purchased in the exchange qualify as employer-sponsored benefits, participants are protected from discrimination based on pre-existing conditions. Lastly, independent risk-adjustment prevents insurers from cherry-picking healthy individuals. These and more changes to come will increase accessibility, portability, and affordability of health care in Utah.

Utah’s efforts prove that states can get health care reform right if the federal government simply gets out of the way. Conversely, Democrats’ tactics would amount to a Washington takeover of health care, and would, as Feeney writes:

…trample on the traditional preeminence that the states, under current law and the Constitution, have long held in enacting and improving the regulation of their very different health insurance markets.

Washington lawmakers should make changes at the federal level that make it easy for other states to follow Utah’s lead, allowing states to tailor reform to their specific needs and to learn from each others’ failures and successes, thereby determining the most effective means of reform.

Kathryn Nix currently is a member of the Young Leaders Program at the Heritage Foundation. For more information on interning at Heritage, please visit: