It's just another instance where the R's don't fund govt and then rail to the people back home that govt doesn't work and it needs to be smaller. It's really quite ingenious of them to do with the uneducated, pissed off people in small towns who have been long forgotten and never seem to recover when "recovery" of Wall St happens.



Also, there was the 2010 elections that saw a wave of teabaggers in local, state, and federal elections. In FL, (p)Rick Scott has made it illegal for state workers to help or suggest anything to anyone about the ACA program. It has been local hospital groups that have been funding "health care" clinics to have someone on site to help people wade through the program and the application process (these hospitals and Drs do want to get paid and have less uninsured eating up their costs in ER rooms).



Plus, when the Supreme Court changes the Medicaid Expansion to be optional for states to take, it created a monster of making those in many red or R controlled Gov states to choose to opt out. This made the Federal Exchange website the de-facto site for signing up for many uninsured Americans. Places like CA, who did take the time to set up the exchange and take the Medicaid expansion program, easier for those living in that state to shop around... And has made better plans and cheaper plans available... There are going to be many people stuck in the middle; where they are too poor for a plan and too wealthy to qualify for the states Medicaid services under the current state's criteria.



It will get worked out. People have until March to initially sign up. And if we can turn some of these states back to blue and the House back to blue, they can start fixing the issues around the edges of the law. Also, with so many states making the Federal Govt the de-facto "go-to" for health insurance shopping, there may be a way for the Fed Govt to create a Public Option because they are in a state where they would have qualified for the expanded Medicaid program if the state had opted in. With so many states being stubborn, we may end up with Medicare for All faster than if each state had set up their own exchange.



It's also going to become a selling point for new businesses, for people to move to, and for some states to get "bigger". If a Tate has incredible health ins/ care plans, and the costs of insuring people are less of a burden on a business, then that would be taken into consideration with investors. Bottom line on cost savings is going to be a factor. And people move toward jobs and growth and better services. If you live in one state that has teabaggers who refuse to implement the ACA, and the state next door can literally save your family's life with access to affordable insurance and Dr care, there is going to be incentive for a family to make a move; especially if they have any family members that have medical needs on a fairly regular basis.



By 2017, when states can choose to go with a Medicaid for All program, I believe a handful of states will be ready to switch over to that model and cut out the middleman (ins co's), that want to take off with 20% in profit. I could see some states coming together to enact these types of public programs, like New England and NY combining resources and working together to share the health care costs among more people so that their costs for care can decrease as a total. On the west coast, CA, OR, and WA could combine together to create a West Coast public health care model. Once a few of these states work for the people, it's only a matter of time before the insurance Co's are obsolete from the picture. If they were smart, these ins co's would be thinking outside the box and come up with a different formula for making money... Maybe becoming supplemental ins programs? But really, they are not necessary in the total picture.



In the meantime, the Govt and people as a whole will have to think of where the many, many people who work for these insurance companies will go to for work? Some will move over to processing the claims for the Federal Govt or State Gov, but not as many who are currently in the business. By creating these exchanges, we are creating more jobs for the ins industry... And like the "war time" economy that we've been stuck on since WWII, the industry will make it hard for the reps in different states to de-fund them because it means jobs will leave the area. There is a reason the War Machine places industry in all 50 states and employs a certain amount of people to make tanks and planes and missiles that we don't need.



It's really past the time we examine what life is worth? How many hours should be spent working for a livable wage? And what types of jobs should be invested in for our future. Renewable energy, public transit, small family farms/ co-ops of younger people to grow crops in a sustainable manner (rather than the poisoned, Monsanto, nutrient depleting manner in which the factory farms currently do)... And who is more valuable? The banker who shuffles paper and 0's on a spread sheet OR that family farmer producing actual life sustaining fuel for people to survive?