Frequently I hear that we should "Return power to the States" because they are better at "Tailoring services to the needs of their population." Usually this is code for "Let states screw their population out of social services," but even if it were done fully in good faith, and did not have the net impact of cutting care, for areas like healthcare this just does not hold up.
My needs for healthcare are exactly the same in Texas as they are in Massachusetts, and more importantly a poor rural Texan has the exact same healthcare needs as a rich Bostonian. Namely, both need access to preventative care when they're healthy and good hospitals for when they're sick. Medicare does a great job paying for this in seniors, and saves money by doing all of the administrative stuff only once (rather than once for each state), so why the fetishization of giving control to individual states?