The federal government is the dominant entity in our lives, not the states; this will not change, in spite of the Dobbs decision. The Affordable Care Act, a most heinous legislation that, more than any in modern times, blatantly usurps the rights of the individual. It is clearly unconstitutional, but SCOTUS doesn’t seem to care, as it remains legally complete and intact. The court’s most recent decision on the ACA was only last year; at that time the concept of “federalism” apparently wasn’t strong enough.
SCOTUS Upholds Obamacare 7-2 With Kavanaugh, Barrett Joining the Majority
from public integrity.org: (not a link)
When the Affordable Care Act (ACA), or Obamacare, was initially enacted in 2010, the healthcare reform law was contentious, to say the least. Several groups and even states filed lawsuits contesting parts of the law, or the entire program.
Although the law went through a number of adjustments as the rollout continued, the law held up under lawsuits going all the way up to the Supreme Court and implementation proceeded. Even so, several states have attempted to find ways to opt out.
However, the ACA is a federal law, and no individual state can opt out. Every U.S. citizen is required by law to obtain health coverage that meets mandatory minimum standards or face penalties for failure to comply.
Unless I missed some news the “penalty” is still $0 from the Trump administration.