Jonah Patel
The COVID-19 pandemic has brought to light the complex relationship between federal and state powers in the United States. While the federal government has the authority to regulate interstate and foreign commerce, including imposing quarantines and other health measures to prevent the spread of diseases, the Tenth Amendment of the U.S. Constitution grants states the authority to control the spread of dangerous diseases within their jurisdictions. This amendment gives states the power to take public health emergency actions, such as setting quarantines and business restrictions, and has allowed states to take the lead in responding to the pandemic. However, the pandemic has also driven at least eight states to enact measures limiting the authority of public health officials, citing dissatisfaction with their actions during the crisis. This dynamic between federal and state powers in public health has been a critical aspect of the U.S. response to the COVID-19 pandemic and continues to shape the country's approach to safeguarding the health and safety of its citizens.
| Characteristics | Values |
|---|---|
| Amendment Number | 10th Amendment |
| Powers Granted | Authority to take public health emergency actions, such as setting quarantines and business restrictions |
| Powers Exercised Over | Local governments |
| Relationship with Federal Government | The federal government has the power to quarantine and impose health measures to prevent the spread of diseases from foreign countries, as well as between states |
| Supreme Court Rulings | In 1824, the Supreme Court ruled that police powers, including the ability to impose isolation and quarantine conditions, are largely reserved for states for activities within their borders |
| Recent Developments | Some states have moved to limit public health powers, especially in the wake of the COVID-19 pandemic |
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What You'll Learn
The 10th Amendment
The Tenth Amendment of the US Constitution states that powers not delegated to the federal government are reserved for the states. This amendment has been interpreted by the US Supreme Court to mean that state governments have the primary authority to control the spread of dangerous diseases within their jurisdictions. This includes the ability to impose quarantines and business restrictions.
The first state-level agency for public health was created in New York in 1866, and Massachusetts established its first state board of health in 1869. In the early to mid-20th century, state and local health departments grew in size and responsibilities, and many of the public health interventions and focus areas that exist today were established and expanded.
The power to quarantine and take stringent measures in the name of public health has belonged largely to the states for almost 200 years. In 1824, the Supreme Court drew a clear line between the state and federal governments when it came to regulating activities within and between states. Then-Chief Justice John Marshall cited the Tenth Amendment, saying that police powers are largely reserved for states for activities within their borders.
State constitutions and statutes specify the powers of local governments. In cases where it is unclear if a state has explicitly granted a power to a local government, most states follow Dillon's Rule, which states that local governments only have the powers that state law explicitly delegates to them. However, many states grant local governments the general power to manage their own affairs, which gives them more governing authority than assumed under Dillon's Rule.
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State vs federal powers
The US Constitution's 10th Amendment, which states that any powers not explicitly assigned to the federal government are granted to the states, has given states authority over public health since 1791. This includes the power to enact and enforce laws that promote the health, safety, and general welfare of their residents. As a result, state governments often have primary responsibility for enacting public health measures and policies, such as setting quarantines and business restrictions during public health emergencies.
However, the federal government still retains some powers over public health. For example, the Commerce Clause gives the federal government the authority to regulate interstate and foreign commerce, which includes imposing quarantines and other health measures to prevent the spread of diseases across state borders or from other countries. The federal government can also leverage funding to influence state and local public health efforts, as seen in the CDC's support for state and local vaccination programs.
The COVID-19 pandemic highlighted the complexities of the federal and state governments' roles in public health. While states had the authority to implement different measures, the lack of a centralized response led to varying death rates and confusion among the public. This has sparked discussions about the need for a more effective balance of powers between federal and state governments in public health emergencies.
The dynamic between federal and state powers in public health is constantly evolving. For instance, the Supreme Court's 2022 Dobbs v. Jackson Women's Health Organization decision gave individual states the power to determine abortion rights, demonstrating how state powers can fluctuate based on judicial interpretations.
In summary, while the 10th Amendment grants states significant authority over public health, the federal government retains specific powers and leverages that can influence state actions. The COVID-19 pandemic and ongoing judicial decisions continue to shape the understanding and application of federal and state powers in public health.
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Public health emergencies
The US Constitution's 10th Amendment gives states the authority to take public health emergency actions. This amendment grants states all powers not explicitly given to the federal government, including the ability to set quarantines and business restrictions to control the spread of dangerous diseases within their jurisdictions.
State health departments play a crucial role in protecting and promoting public health through various governance functions, such as policy development, resource stewardship, and legal compliance. They have the authority to impose isolation and quarantine measures, direct essential workers, and order residents to stay at home during public health emergencies.
The federal government's power in public health emergencies is limited to specific circumstances. The Commerce Clause grants Congress the authority to regulate interstate and foreign commerce, allowing them to implement quarantine measures and other health protocols to prevent the spread of diseases across state lines and from foreign countries. Additionally, the federal Public Health Service Act authorizes the Secretary of Health and Human Services to lead federal public health and medical responses during public health emergencies.
During a public health emergency, such as an epidemic, pandemic, or the threat of bioterrorism, it is crucial to follow official guidelines and recommendations. These may include receiving alerts and warnings, practicing good hygiene, avoiding close contact with sick individuals, and staying at home if you are unwell. While the discussion of a centralized federal response during the COVID-19 pandemic arose, it was ultimately dismissed, highlighting the complex dynamics between federal and state powers in addressing public health crises.
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Local public health agencies
The Tenth Amendment of the US Constitution gives states the authority to take public health emergency actions, such as setting quarantines and business restrictions. While the federal government has the power to quarantine and impose health measures to prevent the spread of diseases from foreign countries, state governments have primary authority over controlling the spread of dangerous diseases within their jurisdictions.
State and local public health agencies are described as the "backbone" of the public health system. However, their roles can be confusing, as states and localities organize their government public health systems differently, and local boards of health vary widely in their functions, structures, and regulatory authority. States exercise complete authority over local governments, and state constitutions and statutes specify the powers of local governments. Most states follow Dillon's Rule, which holds that local governments only have powers that state law explicitly delegates to them. However, many states grant local governments the general power to manage their own affairs, giving them more governing authority than assumed under Dillon's Rule.
Under the "home rule" system, cities and counties are authorized to set up their own systems of self-government, and local officials have more flexibility and authority to adopt and implement public health policies. State health departments have a wide range of responsibilities, including policy development, resource stewardship, and legal compliance.
In Pennsylvania, Act 315, or the Local Health Administration Law, provides funding to improve local health administration by authorizing state grants to counties and municipalities that have established health departments and meet certain requirements. These departments aim to improve community health through direct health services, health education, and community health leadership and control. Act 315-funded health departments provide administrative and supportive services, personal health services, and environmental health services, including food and water supply protection, water pollution control, and solid waste management.
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State constitutions and statutes
The US Constitution does not explicitly guarantee a right to healthcare. However, the Supreme Court has held that the government must provide medical care in specific situations, such as for prisoners. The 10th Amendment gives states the authority to manage public health within their borders. This includes the power to quarantine and impose business restrictions during public health emergencies. State constitutions and statutes outline the powers of local governments, with some granting more autonomy to local authorities in implementing public health policies.
State constitutions may provide constitutional rights that exceed federal standards, particularly in the area of healthcare. Several states have amended their constitutions or passed laws to "nullify" or "opt out" of federal health insurance mandates and provisions. While direct conflicts between federal and state laws would typically favour federal law under the Supremacy Clause, state constitutions can shape the provision of healthcare services.
State legislatures have broad plenary powers and police powers to safeguard their populations' health and safety. They create public health agencies and delegate powers to lower-level agencies, enacting statutes for disease control and prevention. Administrative law, created by these agencies, promotes policy goals through rules, regulations, and procedures. State courts, influenced by each other's decisions, can modify constitutions and statutes to adapt to changing conditions, as seen in landmark cases like Jacobson v. Massachusetts.
The "home rule" system, established through state constitutions or statutes, empowers cities and counties with self-governance. Local officials gain more flexibility in adopting public health policies under this system. However, the relationship between states and localities varies, and Dillon's Rule restricts local governments to only the powers explicitly granted by state law. Despite this, many states allow local governments to manage their affairs more extensively than Dillon's Rule suggests.
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Frequently asked questions
The 10th Amendment gives states all powers not delegated to the federal government, including the authority to take public health emergency actions.
States can order quarantines, restrict the movement of people exposed to a contagious disease, and direct those sick with a communicable disease to isolate. States can also order residents to stay at home except for essential work, food, or other needs.
State health departments have a wide range of responsibilities, including policy development, resource stewardship, and legal compliance, all aimed at protecting and promoting public health.
The first comprehensive public health law was proposed in 1850, and the Public Health Service Act was among the first laws passed by Congress. Over time, more specific public health laws have evolved, and today, public health agencies use their authority to promote health, prevent the spread of disease, and protect against environmental hazards.
Yes, some states have passed legislation to limit the authority of public health officials, particularly during the COVID-19 pandemic. These laws can restrict public health officials' ability to address the pandemic effectively and pose serious risks to public health.
