JAMES TARANTO: Laboratories of What? The clichés of ObamaCare coverage.

Ironically, before ObamaCare the medical-insurance industry functioned very much according to Brandeis’s “laboratories of democracy” model. “Thanks to the McCarran-Ferguson Act, which was passed in 1945, each of the fifty states has the exclusive power to license health insurance within a state’s own borders even if, in doing so, a state directly burdens interstate commerce by shutting out-of-state insurers out of the market,” as Steven Calabresi explained in a 2013 article for the University of Cincinnati Law Review.

“The McCarran-Ferguson Act purports to allow state governmental discrimination against inter-state commerce that would otherwise violate the Dormant Commerce Clause,” Calabresi argues, referring to the doctrine that states may not regulate interstate commerce. “It is this statute that has created the state health care oligopolies and monopolies and which is the cause of all our health care woes.”

But while McCarran-Ferguson deprived consumers of the benefits of competition across state lines, it did allow states considerable leeway to experiment. Some enacted coverage mandates; others didn’t. Some imposed “community rating”–a ban on charging higher premiums to policyholders with pre-existing conditions–and some repealed that requirement when it proved uneconomical. Massachusetts established an individual mandate, which most critics concede was (in contrast with the federal version) a constitutionally permissible exercise of state police power.

ObamaCare left the state-based regulatory scheme in place while overlaying upon it a panoply of new federal mandates. One of the few policy choices states have–to opt in or out of the Medicaid expansion–was not even part of the law until the high court found, also in NFIB v. Sebelius, that Congress had exceeded its powers in threatening to cut off existing Medicaid funding to states that did not go along.

So what we have with ObamaCare is the worst of both worlds: state monopolies without the flexibility to innovate.

Too bad nobody read it before they passed it so we could find out what was in it.