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As a Canadian, I'd like to ask you a couple of things.
What exactly does it mean to codify something? Two, why can't the Federal Gov put out a set of standards and say, "If you want Federal money for your healthcare systems, you have to meet these standards. If you don't want to, that's fine, but in that case you get get nothing from us."
That's essentially how it works in Canada between our Federal gov and the Provinces, granted Canadian Provinces are less powerful than American states, but the power of the purse should still be the same, yes?
That’s how the minimum age for purchasing tobacco used to work in the US; if states wanted a specific chunk of federal funding, their minimum age had to be set to at least 18.