The Affordable Care Act compels individuals to purchase health insurance, and it compels states to expand their Medicaid efforts, a joint federal-state program that traditionally provides health insurance for the poor and disabled. In its 2012 ruling, the U.S. Supreme Court upheld the so-called individual mandate but argued that the federal government does not have the constitutional authority to compel states to expand Medicaid. Should the federal government be involved in state healthcare? What role do state governments have in maintaining public health, and what are the advantages and disadvantages of federal involvement?

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