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The fed was going to run it all anyway they just wanted the states to pony up the money to start the exchanges. Lot of states said no you go ahead and pony that money up yourself.
And so much for States rights. Just let the Feds run all the programs.
Well since they didn't open insurance commerce across state lines, the Fed has to customize it for every state and use insurers from that state for that state's pool.
The states never wanted that right to begin with so they are not really losing anything.
If the states ran it they would still be under the thumb of the Fed because the Fed gets to make all the rules but won't guarantee 100% reimbursement if it overruns that $2 billion.
IMHO it's a good fiscal move by the states. States don't have printing presses and have to run within a budget.
IMHO it's a good fiscal move by the states. States don't have printing presses and have to run within a budget.
More than that, it would **** off their political contributors... the largest and most influential insurance companies who would be only one of many insurance companies in the list people would end up shopping for.
Sounds like a pretty high level of bureaucratic confusion involved, with several govs expressing frustration at the lack of information coming from HHS. Pres. Obama managed to get it passed (barely), got it through the courts, but it remains unpopular with over 50% still favoring repeal. CNN Not Reporting Own ObamaCare Poll
Implementation will be a big test for Obama in his second term He's going to have to somehow make sure that ACA does not turn into his Iraq. No doubt his team is great at campaigning, at winning elections, and at winning PR battles. I don't see the evidence that they are great at implementation.
Sounds like a pretty high level of bureaucratic confusion involved
Not to those with functioning brain and a desire to work for its people. MANY states have taken advantage of the opportunity. Those with slower brains pushing them, are understandably lagging behind (for now, until booted out).
I like how the Canadian government does it. If a province does not conform to the Canada health act then that province gets NO federal money at all. Since that money is something like half the provincial budgets they could refuse to implement or freeze in the dark.
Well since they didn't open insurance commerce across state lines, the Fed has to customize it for every state and use insurers from that state for that state's pool.
That is correct and if I were Obama I would delay the implementation of the exchanges for the opt out states until those states that set up exchanges were up and running and then when the opt out states see the benefits that they are missing... well it would be fun. Unfortunately and contrary to conservative opinion Obama isn't as politically devious as I would be.
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