Such ‘cooperative federalism’ arrangements under which the federal government gives states incentives to administer or enforce federal programs are very common, including in the field of health care. Many conservatives and libertarians myself included view them with suspicion. By contrast, left of center federalism experts often praise them on a variety of grounds: they enable the federal government to make use of state officials’ local knowledge; they provide incentives for states to promote important national policy objectives; they avoid unnecessary duplication of federal and state bureaucracies; and they enable greater sensitivity to local diversity particularly important in the health care field, where there are many complicated variations in local conditions and relevant state regulations. State-led implementation of federal programs might also enable them to operate with greater sensitivity to the needs of politically influential local constituencies, thereby building a broader base of political support for the program. Considerations like these led Peter Harkness of Governing magazine to to suggest, back in 2012, that the ACA’s reliance on state-based exchanges could make the law a cooperative federalism ‘model for healthy state-federal relations.’

via Why the DC Circuit’s interpretation of the ACA in Halbig v. Burwell is far from “absurd” – The Washington Post.