The federal government has worked to expand healthcare reforms to give all citizens access to affordable health care. States such as Washington chose to expand their Medicaid programs, giving more citizens access to free or low-cost healthcare. States such as Texas have opted not to expand Medicaid programs, leaving low-income citizens without access to affordable health care. Which of the following concepts best describes the states’ actions in the scenario?

- nullification
- dual federalism
- cooperative federalism
- laboratories of democracy