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Abstract How does the state of American federalism explain responses to COVID-19? State-by-state variations to the COVID-19 pandemic illustrate the political dynamics of “kaleidoscopic federalism,” under which there is no single prevailing principle of federalism. In the COVID-19 pandemic, features of kaleidoscopic federalism combined with shortcomings in the public health system under the Trump administration, leading to fragmented responses to the pandemic among the states. Federalism alone does not explain the shortcomings of the United States’ response to the pandemic. Rather, the fragmented response was driven by state partisanship, which shaped state public health interventions and resulted in differences in public health outcomes. This has sobering implications for American federalism because state-level partisan differences yield different and unequal responses to the pandemic.
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This content will become publicly available on February 1, 2026
Views From State-Level Policy Actors About the US Federal Government COVID-19 Response
The United States takes a federalist approach to pandemic responses while the bulk of pandemic powers sits at the state level. Thus, comprehensive accounts of how state health officials managed the crisis and how the federal government affected those efforts are needed to better understand the governmental response to the COVID-19 pandemic. This article reports the results of semistructured interviews with 29 state-level policy actors from 16 US states. Interviewees discussed multiple aspects of the US federal COVID-19 response that affected the response in their states, including communications with the public, intergovernmental communications, and federal actions regarding various aspects of health service preparedness including emergency funding, procurement, testing capacity, vaccine development and distribution, and data systems. This research enriches the discussion about US pandemic preparedness and response, and indicates that alignment of public communications across government levels, enhanced intergovernmental communication, inclusion of rural perspectives, and federal investment in and sustainment of health service preparedness are key factors that can improve future US pandemic responses.
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- Award ID(s):
- 2122574
- PAR ID:
- 10611970
- Publisher / Repository:
- Mary Ann Liebert, Inc.
- Date Published:
- Journal Name:
- Health Security
- Volume:
- 23
- Issue:
- 1
- ISSN:
- 2326-5094
- Page Range / eLocation ID:
- 1 to 8
- Subject(s) / Keyword(s):
- COVID-19 Pandemic, Policy Public health preparedness/response Crisis response
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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