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Until the Nixon Administration, federalism was not talked about much in the United States in the post-New Deal period and was not taken seriously as an intellectual matter. Increasingly, however, federalism has become an important domestic' and a critical worldwide issue. It may not be an exaggeration to say that federalism has indeed become the pervasive legal/political issue around the world. In this Article I will make four points. First, by way of background and overview, I will conclude that the goal of federalism is and should be to encourage and facilitate geographically-based political autonomy without placing at risk the interests of minorities within those autonomous areas. Second, I will examine federalism as a civil rights paradigm. My thesis is that federalism, as a political principle and as an institutional structure, is an important form of decentralization in decision making in the cause of autonomy, democracy, and freedom. There is, therefore, an essential complementarity between the principles of federalism and traditional principles of civil rights. At the same time, there is an inherent tension between those principles. The traditional civil rights paradigm protects individual liberties by resort to universalistic principles such as equal treatment regardless of race, religion, or gender. Federalism may protect minorities based not on universalistic norms, but upon ascriptive criteria such as geography or ethnicity

Increased attention is being given to questions of institutional structure in US public policy. A number of areas are examined in which this is true, including social services, civil rights, separation of powers, & reassertion of the role of states, private initiative, & the family as against that of the federal government. This new interest might in time lead to a revitalization of theoretical analysis of institutions & of political economy as a field. W. H. Stoddard.

Much has been written about the change in the Supreme Court's judicial philosophy, as a new, ascendant majority has been able successfully to implement its emerging notions of judicial reticence and self-abnegation. This fundamental turnabout in judicial perspective is hardly coincidental, since it reflects the fulfillment of an oft-repeated campaign pledge of Richard Nixon, who in 1968 promised, if elected, to appoint so-called strict constructionists to the Court.' In a basic way his appointees have succeeded in modifying the activist stance that prevailed on the Court during much of the tenure of Earl Warren as Chief Justice. With notable exceptions in some areas, the new majority has a much more modest view of the judicial function within our democratic society.' Elements of his philosophy have emerged and been acted upon in such fields as individual rights (especially equal protection), access to the federal courts (for example, standing), and federal-state relations (for example, revivification of the eleventh amendment and resurrection of the doctrine of comity as limitations on federal judicial activity)." The overriding themes appear to include judicial self-restraint, reliance on and faith in the democratic process, skepticism about the wisdom and effectiveness of active judicial intervention in the resolution of basic societal disagreements," and a certain nervousness about continual confrontations between the Court--an institution perceived by many as undemocratic and counter-majoritarian-and popularly elected, and therefore politically accountable, legislative and executive officials.

With judicial reform a matter of intense public debate, it is essential that one understand the political consequences that may result from the adoption of various reform measures. Moreover, it is important to recognize that an evaluation of any proposed change must proceed from one's conception of the role of the Supreme Court in our society and one's perception of the foundations of its legitimacy. Similar considerations also must shape one's analysis of the rule of four and the Court's practice of dismissing certiorari as improvidently granted. While discretionary review increasingly has politicized a large portion of the Court's work, a political decision to grant review should be treated with the respect due an institutional determination of the Court. Before proceeding to reverse itself by dismissing certiorari, the Court should articulate reasons for its ultimate refusal to hear a case. In this way, a common law of precedent will evolve that would limit this form of dismissal; since other techniques for avoiding adjudication on the merits, such as the abstention doctrine, have an intellectual content of their own, so should writ dismissals. In deference to the principle of minority control of the screening process, however, certiorari should not be dismissed as improvidently granted if four of nine or three of seven Justices dissent.

The legal issues underlying the California delegate challenge at the 1972 Democratic National Convention are the subject of this Article. The Article briefly will sketch some of the recent constitutional developments in party reform litigation. It will argue that winner-take-all primaries, especially in California because of its size, are violations of equal protection as interpreted by the voting rights cases decided during the past 40 years. Finally, it will take the superficially paradoxical position that despite its unconstitutionality, California's winner-take-all primary did not violate the rules governing delegate selection to the 1972 Democratic National Convention; therefore, unless declared unconstitutional by a court, the 1972 Democratic National Convention should only have invalidated California's winner-take-all primary prospectively. Of course, that is in fact what happened after all the turmoil had ended.

TennCare is a Medicaid demonstration project that allows Tennessee to require all Medicaid beneficiaries to secure medical care through a mandatory managed care system. Enrollees contract with private managed care organizations ("MCOs'), which are responsible for organizing a network of care providers and delivering medical care to covered beneficiaries. Driven by rapidly escalating Medicaid costs, TennCare's mandatory managed care program has succeeded in saving money for the state in its Medicaid program. To secure the federal waiver that allowed the program to proceed, the state included non-Medicaid-eligible uninsured and uninsurable residents as TennCare beneficiaries. Federal matching funds accrue for all TennCare expenditures, including those for non-Medicaid-eligible enrollees, but federal matching is subject to a global cap. Cost savings from managed care were to pay for the improved access. The program covers about 1.3 million persons, 38% of whom are non- Medicaid-eligibles. The Medicaid component of TennCare has been stable, but the non-Medicaid-eligible TennCare population has risen by about 41% in the last two fiscal years, stressing the fiscal capacity of the program. The Article provides background on the development of TennCare, describing the political effect of the federal matching (cooperative federalism) aspect of TennCare on both state-level and federal- level decisionmaking. The Article identifies what it describes as the political moral hazard dimensions of these federal-state partnerships on state political decisionmaking and the correlative lock-in effect of the program on the state. Federal matching funds make program enhancement appealing and make cutbacks extremely painful. The interaction of state and federal program incentives is considered in depth, and both the state responses (use of private funding and provider-focused taxation) and federal responses (limits on federal matching for those sources of state revenue) to these incentives are described and analyzed.

Throughout the 1970s, the two major political parties espoused some form of national health insurance. Faced with a fiscal squeeze, however, the Carter Administration gave national health insurance a relatively low priority.The political movement for comprehensive national health insurance rests on an ideological commitment that the federal government should underwrite the cost of providing universal access to medical services. The objective is essentially redistributive in nature: equitable concerns for the disadvantaged loom as the major focus. The selective expansion of coverage to encompass those identified as needy and worthy, but only those so identified, is anathema to those who traditionally support broad national health insurance. These proponents would contend that a universal and comprehensive program is necessary to avoid a dual system of medical care delivery--one for the poor and another for then on poor. Advocates of a universal program would, in effect, compel the nonpoor to fund and participate in a governmentally sponsored program designed to benefit the poor so that the medical care system operated under government auspices would not be confined to lower income persons and, implicitly, stigmatized as welfare medicine of lower quality and lower status.The access gap between rich and poor-a disparity that underlay much of the political initiative for national health insurance-has been narrowed in recent years at least partly because of Medicaid and Medicare. Overall expenditures on medical services have escalated dramatically during the past two decades and occupy an increasingly large component of our national income. Few people would now maintain that aggregate medical care spending is substantially too low. To the contrary, skeptics point out that structural institutional relationships in the medical sector encourage ever-expanding medical expenditures." Coupled with a growing awareness of the importance of nonmedical factors in the promotion of health, this fact has led to general ...