What is conveniently ignored by "originalists" and other faux-constitutional argumentists, is that the Constitution created a federal government to address issues that cross State boundaries. (Ironically, Republicans are touting exactly that when arguing to allow insurance companies to sell across State lines.) Americans are mobile, and many issues need to have national/uniform solutions. Health care is one of those issues, directly tied to "the general welfare."

Take, for example, a truck driver. A truck driver, by definition, routinely crosses State lines. Should his health care be determined by his route? Or a vacationer. Should my health choices be limited by my recreational location? Both activities involve "interstate commerce", a subject explicitly given to the national government by the Constitution (for very obvious reasons).

One solution would be for the federal government to simply mandate minimum coverage requirements and let States decide how to provide it. Oh, wait... That's the ACA. I GUESS IT'S CONSTITUTIONAL AFTER ALL.

I completely agree the "States rights" argument is bogus and a deliberate distraction. That there is an ideological cabal on the Supreme Court that refuses to adhere to the actual Constitution doesn't make it any less so. Provision of health care to all Americans is a national crisis that is not amenable to State-by-State or market-based solutions, as centuries of history demonstrate. The ACA was never intended to be a final solution, but a start.

By the way, the argument that it will fail on its own is also completely bogus. For nearly a decade Republican ideologues have been trying to kill it, hamstring it, undercut it... And STILL millions of Americans are getting healthcare because of it, and premiums are rising at lower rates within the exchanges, rather than outside of them. The ACA provides more choices than non-ACA markets (contrary to another Republican lie). Were​ it not for ideological interference, millions more Americans would already be covered, premium rises would slow further, and markets would stabilize. That's the facts, Jack.

A well reasoned argument is like a diamond: impervious to corruption and crystal clear - and infinitely rarer.

Here, as elsewhere, people are outraged at what feels like a rigged game -- an economy that won't respond, a democracy that won't listen, and a financial sector that holds all the cards. - Robert Reich