I will point out again that the first person who questioned this practice is the highly regarded liberal, Daniel Patrick Moynihan.
This isn’t a liberal/conservative issue, and if you believe it is, then you really don’t understand it. It’s quite easy to focus on the simple part of this equation (rural states vs industrial states) and believe that this is all goodly charity on the part of the industrial states, but as long as we are a union of states rather than a single integrated nation, then the distortions caused by the practice must be accounted for.
Switzerland, a nation which can hardly be called “conservative” by US standards, with universal health care and a fully fleshed out social welfare system, operates on a federalist principle. The federal government sets standards for policies and programs to be executed by the states, which then set their tax rates and execute on them. Federal taxes are lower as a % of overall taxation than in the US, and state (cantons, they are called) taxes are higher as a % of taxation.
Seems to work well.
Also, the fact that you create such a system, of course, does not mean you CANNOT also have certain national-level programs which are best executed centrally. As you point out, FEMA is a good example of a program which doesn’t make sense to execute locally.
Believing that the current US system is the only one that would work is demonstrably false.