Federalism is defined as the allocation of responsibility and authority between the states and the federal government. All of the states have surrendered a portion of their authority to the federal government. This helps to create a balance of responsibility between the states and the federal government. Ultimately, the power of the federal government is supreme which means that the federal government can step in if necessary (George Washington University, n.d.

). State control allows the states to set their own policy, which is common when an issue is new on the political scene. State control is favorable in situations where the state can experiment with policies that would be too risky at the national level. This then allows the states to tailor the policies to meet the local needs. However, over time the federal government may choose to step in as with HIPPA for example.

Federal control is when the federal government sets the policy. This is necessary when uniformity is needed when responding to crisis or achieving national goals. The federal government also has the ability redistribute resources for effectively due to the large base (George Washington University, n.d.).            In 2010, President Obama enacted the Affordable Care Act also known as Obamacare. The ACA allowed individuals to purchase healthcare insurance through a system of exchanges, tax credits, and subsidies.

In 2012, the Supreme Court also made the expansion of Medicaid voluntary for states. Under this law, healthcare services are required to provide a standard set of benefits and are prohibited to deny individuals based on pre-existing conditions (Ballotpedia, 2017). I choose to research the Affordable Care Act’s impact in Virginia because I was born and raised in Northern Virginia. Between 2013 and 2016, the number of uninsured individuals in Virginia declined from 991,000 to 715,000, which is a 27.9% decrease. As a percentage of the population, the portion of uninsured individuals in Virginia fell from 12.3% to 8.

7% (Ballotpedia, 2017). As of September 2017, Virginia was one of 28 states with a federally facilitated health insurance exchange. Out of the individuals enrolled, 83% were eligible for premium tax credits and approximately 60% were eligible for reductions in the cost sharing responsibilities, which means that their insurance plans covered more of their costs (Ballotpedia, 2017).


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