In the United States government, there are state and federal set of legislations. Legislation passed and enforced by the State government is limited to the citizens who live in that specific state. You have to adhere to the laws of that specific state.
Federal laws have to be followed by all citizens every state that is in the United States of America.
As society advances, new challenges arise and with that, new solutions (for example: new trials and court cases that have had an impact in what society accepts as normal social behavior). Unfortunately, there has been federal legislation that contradicts, or rather, don't correspond with state legislations.
When we look at this issue from a public health perspective, we can see that there have been federal laws that goes against state laws in regards to the development of medical care among the 50 states. For example: Federally, pro-life states can’t legally discriminate against women. However, some states do discriminate against women seeking or receiving certain medical resources and medical treatment (abortions, Roe V. Wade).
The federal government layers the standards for the ability of basic health care service (ex: Obamacare) and can pass a federal law, or an amendment to the constitution.
On the state level, there has to be standards of sufficient health care rights and people have to be proactive and identify sub-standards that are deemed as acceptable on a state level.
There is a lot of bureaucracy and compromising that comes with moving health legislature. By the time a new health bill does find itself in the hands of Congress and does comes to pass, the reasons as to why it should be supported has changed or, the bill itself has changed from what it was once originally was. We need a cohesive intergovernmental process that allows the prompt response to improving and expanding affordable health care that provides sufficient coverage for all people.