The national health care debate has turned into a broader debate about the size and scope of federal power, and our congressional leaders need to become agents of a new constitutional vitality, animated by a deep and dutiful devotion to the Constitution’s fundamental principles of liberty, limited government, and federalism. This means that, to guide our thinking as we grapple with the question of how to reform health care, we must repair to the Constitution. To make health insurance accessible and affordable for millions of Americans, Congress must do its job under the Constitution, not outside of it. In doing so, Congress can also take advantage of the federal system itself, the division of powers between the national government and the states, and allow states to experiment with big ideas.