Expanding Capacity for Health Outcomes Act of 2026

The proposed amendment to the Public Health Service Act may be justified under the spending power (Article I, Section 8, Clause 1) to provide for the general welfare, or under the commerce power (Article I, Section 8, Clause 3) if it regulates activities substantially affecting interstate commerce. However, if the bill imposes direct mandates on states without offering federal funding or exceeds the scope of enumerated powers by intruding upon areas reserved to the states under the Tenth Amendment, it would be unconstitutional. The ambiguity of the bill's text—specifically whether it creates n…

This bill, which expands federal capacity to improve health outcomes and increase access to specialized care under the Public Health Service Act, exceeds the limited powers delegated to Congress by the Constitution. The regulation of health and medical care is a matter of internal police power reserved to the several States, not a power enumerated in Article I. The Commerce Clause does not authorize Congress to regulate all matters of health, and the General Welfare Clause is a limitation on spending, not a grant of plenary authority to legislate on health. The Tenth Amendment affirms that pow…

The bill's stated purpose—expanding capacity to improve health outcomes and increase access to specialized care—falls under the general welfare, but the Constitution grants Congress only enumerated powers. Under Article I, Section 8, Congress may tax and spend for the general welfare, but this does not authorize direct regulation of medical practice or healthcare delivery, which are reserved to the states by the Tenth Amendment. If the bill merely provides conditional grants to states or incentivizes state action without coercing them, it may be permissible under the spending power, as discuss…

This bill, which seeks to amend the Public Health Service Act to expand capacity and improve health outcomes, must be examined under the principles of enumerated powers and necessary and proper means. The Constitution grants Congress the power to provide for the general welfare and to regulate commerce among the several states (Article I, Section 8, Clauses 1 and 3). However, the general welfare clause is not an independent grant of power but a limitation on the taxing and spending power, as established in McCulloch v. Maryland (1819), which held that Congress may employ only means that are ap…