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    Standing up to ObamaCare: Where the States Stand on Exchanges

    Use this page to find out where your state stands on the ObamaCare "exchange" - and to help us stand up to ObamaCare.

    Since the election, now fully two weeks ago, health policy experts such as our own Dean Clancy have been eagerly pointing out that those of us who believe in limited government still have a very real opportunity to halt one of the largest government intrusions of the past century - ObamaCare.

    Blogger Rusty Weiss has presented a good, concise summary of how a number of states refusing to set up ObamaCare's health care exchanges could throw a wrench in the implementation of the law.

    As several governors have noted, these exchanges will be largely federally controlled anyways, so why should states waste their time and resources setting them up, when refusing to do so could prevent the government from invading their state's health care system at all?  The deadline to set up a state-run exchange was November 16th.

    Below is a map showing where each state currently stands on the health care exchanges:

    Exchange Map

    Happily, twenty-six states have stated their intentions not to set up a state exchange:

    Alabama,   Alaska,   ArizonaFlorida,   Georgia,   Indiana,   Kansas,   Louisiana,   Maine,   Michigan,   Missouri,   Montana,   Nebraska,   New Hampshire,   New Jersey,   North Dakota,   Ohio,   Oklahoma,   Pennsylvania,   South Carolina,   South Dakota,   Tennessee,   Texas,   Virginia,   Wyoming,   Wisconsin

    Having nearly half of the states resist the ObamaCare exchanges is a major problem for the administration.  Some folks in the media, of course, have criticized these states for refusing to "get with the program".  Our Vice President of Health Care Policy, Dean Clancy, has this to say in reply...

    But for residents of these states, it is important that you remain vigilant and encourage your governors to hold the line, because they now have another month during which they could be pressured to change their minds.  The Department of Health and Human Services has pushed the deadline for planning to set up an exchange to December 14th of this year.  However, states can still opt into a federal/state partnership exchange until February of 2013.

    The remainder of the states (AR, CA, CO, CT, DE, HI, IA, ID, IL, KY, MA, MD, MN, MS, NC, NM, NV, NY, OR, RI, VT, WA, WV)  have declared their intention to implement either a partially or fully state-run exchange.  This does not mean, however, that residents in those states should give up hope.  IdahoIowa, Kentucky, Mississippi, North Carolina, and New Mexico are six states where a determined grassroots outcry could cause their governors to perhaps think twice about their decision, and in all of these states it would be constructive to contact your state governments to let them know your thoughts on their decisions.  

    As a last note, it is worth pointing out the case of Utah, where the situation is decidedly different from most other states.  Utah had already established a state health care exchange before ObamaCare was even passed. However, this exchange was extremely tailored to the state’s needs and is in many ways incompatible with the health care law’s requirements of state exchanges.  It remains to be seen whether the federal government will attempt to force Utah to bring its exchange into compliance with federal law, and that fight will bring up fundamental questions of federalism – a state’s ability to chart its own course within an increasingly monolithic federal government. 

    29 comments
    Tamra Moore
    04/05/2013

    Why is Health care becoming so much more difficult in the states that want universal health care? I'm talking about coverage on the the people that previously were covered but all of a sudden through budget cuts are no longer covered.

    Is this a plan to shift the less fortunate into thinking universal Canadian health care will work for America? The thing that worries me is that I will be no better off. Those that can afford health care won't be either to take care of me because they might have health care issues that wont be covered even thought they are doctors, that will impact me my treatment.

    If we go to universal health care....we don't have women's voices on abortion in America. Maybe that will make the government wake up and make MEN pay their child support regardless of their military situation or drug addiction issues....You want abortion to stop...induce a national health care plan and never mind the fact that men need to step up to the plate and support the children the make while FUCKING a WOMAN.

    Lets get to the heart of the matter. Obama is playing both sides here. Christians don't want to pay for abortions....but Daddy's don't have to pay for their children like Obama's daddy didn't raise him either. Did Obama's daddy pay child support or did the hard working Grandparents in America support Obama?

    Starve the folks long enough and they will agree to anything. I believe that this is nothing but a ploy to take over the people. We have a choice. I decide to hold men in America accountable in raising the children they produce. This would help our poverty welfare situation and reduce the need for universal health care reform.

    Scott Weems
    12/07/2012

    If you look at the States that have rejected Obamacare they are the ones that believe in big government and are in the most financial trouble.

    Michelle McGurk
    11/30/2012

    Rosie Wood-It is NOT the federal goverments job to proide healthcare. That is why there are so many different independent (should be independent) insurance providers. Insurance & helathcare costs have sky rocketed in the last few years making it difficult for some people to buy insurance-but guess who's fault THAT is? The FEDERAL GOVERMENT's. Wanna know WHY? Because they won't, they REFUSE to do any thing about the ILLEGAL immigration that is invading & taking advantage of the healthcare system. If our federal goverment did what it was designed to- which is protect our country from being invaded instead of over reaching itself to our pocket books our nation would not be as corrupt or as vulnerable as it is. NO OBAMA CARE. And by the way, have you even READ what is in OBUMMER Care? Read, & read closely. You just may change your mind about how you feel about a so called "univeral/national health insurance." It's a load of crap. NO TO OBUMMER Care.

    Shelly Gage
    11/29/2012

    Rosie Wood - we HAVE universal health care in this country. Walk into any emergency room and you'll find people with no insurance who aren't even citizens getting medical treatment (unless it's a hospital where Michele Obama sits on the board - they'll be busing those "undesirable" patients to different hospitals). We have the world's finest health care system - that's why people from Canada, the UK, and everywhere else around the world who can afford it come HERE for treatment rather than using the "care" their home nations offer. Have you looked at waiting times in countries with socialized health care for access to things like MRIs, CAT scans, cancer treatment, pain management, etc.? The numbers are APPALLING. Please tell me how that's more "compassionate"? I had a friend who had a growth on his pituitary. They found out when he passed out at work. One week later he'd had surgery and was on the mend. If this had happened in Canada, he's still be waiting to get into the MRI!
    I'm glad you're so pleased with your socialized health care but here in the United States of America we are not going to settle for substandard care.

    Joseph Montgomery
    11/25/2012

    Obamacare has nothing to do with healthcare. Its all about control. If It was about healthcare, the government could go purchase private health insurance for the 40 million people without insurance for way less money than Obamacare will cost.

    The Rosie chick from Australia has lived as a socialist too long. When you remove the profit motive from anything, you also remove the efficiency.

    I dont know know about Australia but, other than military, what does government do that private sector couldnt do better.

    Its all about control.

    Concesa Cockrell
    11/25/2012

    Obamacare should have been designed for those individuals who does not have healthcare, & needing help to afford it. Leave everyone else out of obamacare who has health insurance. Since the bill was not allocated any money to set up federal exchanges or subsidies why are we still going to do this? Where will the money come from? Taxes?

    Michael Bodnar
    11/24/2012

    @Rosie Wood....you need to understand what the Framers of the Constitution intended for. Each State in the Union is large enough to be their own country. Several of the States alone have a bigger population than the whole of Australia. In fact, "STATE" at one time meant a sovereign nation. The Founders intended the States to be experimental grounds for social change. The Healthcare is a social issue. If the people in a State wanted to have their state implement a state run system such as universal healthcare. Then they can do this. Once a State is able to get an efficiently run system that the citizenry is happy with (of course these States can look at other countries). Other States can follow suit if they wish. If you live in a state that doesn't have it and doesn't want to implement it. And this is on the top of your list as an individual. Have the right to get up and move to a state that has it. Now, lets say that the majority of the States have this universal system implemented. Then their can be a call for a Constitutional Convention to Amend the Constitution and transfer this power from the States to the Federal Gov. Obv once the Amendment is ratified by 3/4 of the States!!!! This has not happened. This whole Obamacare push was ABSOLUTELY UNCONSTITUTIONAL!!!!

    Here lies the Problem. To do this at State level, States need to be able to raise taxes. This is kind of hard to do considering the Federal Gov has been draining the citizenry of each State via the Federal Income Tax code. Take the State of Texas. They get $.80 back in Federal Funds on every $1.00. Some liberal expert idiot was complaining about their move to secede from the Union and was blasting them cause they have lots of roads that receive Federal Funds. Half truth here!!!! If TX was receiving more back than they paid into the system. He would be 100% correct. However, they only get $.80 on the $1.00. They would have no problem standing on their own. I hope they do secede!!!

    Many of those other developed nations with universal healthcare....well, the jury isn't in yet whether or not they have been such a huge success. In fact, many are showing extreme signs of bursting at the seams. Look at the Canadian system. They have very few specialists. So if you have something that is very serious. Many have come to the US and paid out of pocket. The Canadian system is only good for routine minor problems. And even then, it is a slow process. I know people who live their and this is what they have told me. Also, many have gone outside the system and seen private doctors which is actually illegal. However, the politicians are looking away cause they know the system is broke. It usually takes time to see the true face of the end result of massive socialistic programs implemented by heavily centralized governments.

    The private sector is the most efficient way to move money around and to keep prices down and care at the highest level. This Obamacare actually thinks that they can add 30 million people (bigger than ur country) into the system, get better care and will reduce the overall cost. Not happening!!!! We are already seeing a shortage of doctors. Many Doctors are telling their children not to pursue the medical field. Some Doctors have closed up shop. Just to hard to run a practice any longer with all of the regulations. 20% of Doctors have since dropped Medicare/Medicaid patients due the extreme regulations and cost associated. In essence, many Doctors feel that they will not be able to spend the quality time that they need to with patients. My moms Doctor is adamently against Obamacare. She said it will force her to turn her practice into a revolving door where she can only see patients for 10 min, 15 mins tops. It has already started there. She used to spend a good hour.

    Sure their is profit taking. Nothing wrong with this. What u r missing is that this is more efficient than how a gov can handle things at this scope. The waste in the Gov surpasses by far the profit that is taken by the private sector. Once you get gov taking things over. We will see much less choices to choose from. With no back stop if the Gov says no to you. Here is an example.....you place a trade with your stockbroker. For whatever reason they do not place the trade. What is your way of rectifying the situation? You go to the gov agency overseeing the broker. The gov only duty in this example is to punish the wrongdoer and making sure they do what they are supposed to do. Now, lets put the Gov in charge of placing these trades. Now they don't place it for you. Who do you turn to???? Guess you have to go to Smith and Wesson, Glock, Remington, etc....

    Finally, easy for you to have a system in place. You only spend 1.8% of your GDP on Defense. The US spends 4.7% which comes out to approx 711 Billion/yr or roughly 40% of what the world spends. In essence, we have been policing the world ever since WWII. If we would have pulled out of Europe after WWII. Europe would have been at war in another 20 years. In fact, Europe has been fighting amongst themselves even before the Romans days. Our military basically are the mall guards for world trade. Here is something for you to chew on. People complain about us Policing the world. To some degree I agree. Thing is, would you want China doing this or N Korea, etc.... Just so you know there in Australia, China wants your Country and Continent BAD!!!! They want to take u over. Only thing stopping them is the fact the US is the balance of Power on this blue marble. If we go. YOU WILL GO!!! Watch the documentary, "The World Without Us". It is a rela eye opener. Chine is in expansion mode. Something they haven't done for a long time. They want the entire Pacific Rim. They want to push the US out!!!

    Little History on China....we all can thank that lighting struck a part of their Capital back in the 1400s. It burn down a large part of it. Because of this, the people turned on their emperor blaming his expansionist policy for the lightning strike. They once traded all over the world. They had trade ships that could hold Columbus's ships on it deck. Their population around then was around 300 or so million. They were serious about expansion at that time. Then the lightning and the fire and they stopped. They once again became isolationists. Well, now they are becoming expansionists. This could very well mean taking countries over.

    So thank the US for keep the peace as best as possible. If we didn't do so........there would have been many many more wars.

    Just imagine if the US could go from 711 billion to say 400 billion on defense spending. $300 billion would be available to take care of those who truly needed the medical help. Would be a good backstop!!!

    Finally, one of the main reason why the US health system is kind of broke is the failure of the Federal Gov to keep illegals out of it. This falls under the most important duties of the Fed Gov. And she failed. She failed miserably. No one is talking about this. Many use our emergency rooms as primary care centers. In some cases, they have used ambulances for minor headaches. When Reagan gave amnesty to approx 1.5 million. He only did so cause Congress promised to get serious about the border issue and would go along with his spending cuts he wanted. Well they failed. The Demicans want the votes, the Replubicrats want the cheap labor. We now have gov estimates of 12 million here illegally. Heads up, the gov always low balls the number when it is a bad thing. When it is a good thing like savings....they high ball the amt. My estimates for the illegals is between 16 and 20 million. Let this go on for years and years, decades and decades......the system no how good it looked on paper. WILL FAIL!!!! This is just one thing that drove up costs here. I could go on for another week straight typing!!!

    Ryan Tyner
    11/24/2012

    Even if all the states refused to set up the exchanges, this president is above the law and Constitution. Whats stopping him from writing a Executive Order making the states do it. What could we do? What will Congress do? Who will do whats right? They should post the 'Election Map by County' in Congress AND the Senate to remind them how Red we still are.

    Ryan Tyner
    11/25/2012

    So, who is suppose to enforce the constitution if the President goes around it? He took an oath to uphold it.

    Michael Bodnar
    11/24/2012

    Bingo Ryan!!! I laugh when people say, well he is a Constitutional Scholar. I respond by saying, "this doesn't mean he believes in it and wants to uphold it!!!!". It is the opposite. He has been quoted that the problem with the Constitution is that it limits what the Federal Gov can do for you. Well, no shit sherlock!!!!! This was its intention. The intention was for the States to experiment on social issues. So if they failed. Only those in that State failed. Now we do things only at the Federal Gov level. If it fails.....we all fail. Scratch our heads and say...we should have tried it on a smaller level. The private sector experiments in certain markets before they go on a much bigger and broader implementation. WHY? if it fails in a small market. They don't go out of business. If they bypass the small market and go broad!!!! It fails.....bye bye company!!! look at Kurt Schilling and his 400 plus person gaming company. Bankrupt!!! Why, rather than starting small. He started big. Had huge debts, a huge work force. The thing was. He was only producing one game. It failed and the company went out of business. Starting small is the key!!! So for those morons who are for a universal system. I tell them to go to their local government and ask them to do it. They say hell no! We don;t trust them. I respond by saying. "so you don't trust your local politicians. Why in the hell do you trust the politicians in DC that is 500 miles away?" The further away the seats of power are. The more corruption there is. Physical Proximity of the people to the government is the key to keep corruption as limited as possible. At least locally, the citizens have a much easier time gathering at the from sidewalk of the corrupt politicians. Our kids go to school with their kids. We eat and shop at the same places. This is key and the Founders understood this!!!!!

    Dee Mulverhill
    11/24/2012

    Lest we not forget that "the government" doesn't pay for anything. Do you all forget to ask where the money comes from? And what happens when you take competition out of business?

    Michael Bodnar
    11/24/2012

    @Dee the money in essence comes out of the economy. You and I make up the economy. We get taxed or our future generations get taxed. Or we get taxed via inflation. Inflation which typically hurts the poorest, both young and old. A market place (economy) came first. Gov came after this. A gov cannot operate without an economy. An economy can operate without a gov.

    Charles Sherman
    11/24/2012

    What these Obama supporters don't realize is that if they don't have healthcare then the government is going to penalize them and keep their tax refunds to pay for their so called free healthcare. Then we'll see how great Obama is.

    Randy John
    11/27/2012

    No mater what this man (Obama) does they fall at his feet like he is God. So if he takes their refund, it won't mater because then they will say, well he needed it, then he can have it.

    Roy Coleman
    11/24/2012

    hey Rosie obamacare will not give equal healthcare to everybody what is going to happen is doctors are not going to take obamacare just as they are not now taking new medicare or meidcaid patients because of low reimbursements and ask people over in europe and canada how great their system really is i heard a guy who lived in england and needed an MRI and he got it scheduled for a year later and the folks in europe who have money come here for their healthcare and what will happen is we will have a two tier system where the rich will have better healthcare because they have private insurance and if you really want the government making your health decisions then i suggest you move to europe because under obamacare it wont be you or your doctor deciding what health measures should be tajen but a non elected board formed by the government . remember this a person in canada was interviewed by a news sow one time and said the health care in canada was great IF YOU WERE HEALTHY

    Debbie Burke
    11/24/2012

    To the Aussie woman, you have no idea what the hell you are talking about with our system of government, let alone our health care system!!! There is NOTHING in our constitution that guarantees anyone FREE ANYTHING!!! That includes health care!! What will happen here is already happening, doctors are refusing to see elderly patients, and the poor who are on medicaid!! I invite you to research a little before you just go and post the kind of crap you've posted here!!! You might want to start your reading with the U.S. Constitution and then the Bill of Rights, and your long term reading lists should include the Federalist Papers!!! These are our founding documents and our "esteemed" leaders vow to uphold and defend these documents when they are sworn into office!! You need to stay out of our business and try to fix your own damn country!!! I hear that Aussie women don't even have the same rights we as Americans enjoy!!! Again, go pound salt and stay out of our politics of which you no nothing about!!!!

    Nanette Hoover Lawrence
    11/24/2012

    Come on NY!!!!! We don't need or want Obamacare!!!!!!

    Lewis Clements
    11/22/2012

    I will not COMPLY!

    Bill Fullerton
    11/22/2012

    To the Aussie lady, your minimum wage is outrageous your taxes are through the roof, it costs about 50 bucks for a case of beer in your country, take SOCIALIZED health care and stick it. Most Americans would prefer tp pay our own way and let Uncle Sam take of the needy, as well as 3rd and 4 th. Generation welfare recipients.
    MYOB.

    Bill Fullerton
    11/22/2012

    To the Aussie lady, your minimum wage is outrageous your taxes are through the roof, it costs about 50 bucks for a case of beer in your country, take SOCIALIZED health care and stick it. Most Americans would prefer tp pay our own way and let Uncle Sam take of the needy, as well as 3rd and 4 th. Generation welfare recipients.
    MYOB.

    Bill Fullerton
    11/22/2012

    To the Aussie lady, your minimum wage is outrageous your taxes are through the roof, it costs about 50 bucks for a case of beer in your country, take SOCIALIZED health care and stick it. Most Americans would prefer tp pay our own way and let Uncle Sam take of the needy, as well as 3rd and 4 th. Generation welfare recipients.
    MYOB.

    Ronnie Petty
    11/20/2012

    Our Governors and State Legislatures need to start exercising the 10th Amendment.

    Sara Buskirk
    12/27/2012

    I don't understand why people want a Universal Healthcare system! Really? As someone who grew up without health insurance (father was self-employed) we paid as we went. Nothing is Owed to the citizens of this great country! Why do people think they deserve things for Free? What are we teaching the upcoming generations...that they don't have to contribute and still get benefits? If you want a Universal Healthcare system then move to another country and leave ours alone. ;)

    Dianna Soderholm
    11/25/2012

    @Rosie Wood-Rosie--it might behoove you to actually read the health care bill. While there may be a few slim portions that would be okay to adopt, the majority of it needs to be scrapped. I'm sorry but I have read the bill-I will not have my mom and dad's care decided by a panel of non medical personnel. There is also a provision in there that talks about implanting devices that are small enough to fit in the head of a needle so that it can be injected in to people (big brothers way of tracking us). In another section it clearly states that the president and Congress are exempt from this and will continue their cadillac program. (if it is good enough for the people-then why not them)! Please read the bill before you so emphatically state how great it is!

    Ryan Tyner
    11/24/2012

    Rosie, your country wasn't formed by 'Free' people, so I don't expect you to understand.

    Carol Van Sickle
    11/22/2012

    Correction.. Nancy Palosi said to know what is in the bill, you have to PASS it. Well, would anyone else sign a one page contract even, and not read the small print. Not unless you are stupid!

    Carol Van Sickle
    11/21/2012

    The BIG problem with Obamacare is that it is intrusive and big government that is taking over our lives. There are so many tax burdens hidden in the huge document that have no relationship to health. For example, there is a 6% federal sales tax that has to be paid with real estate transactions, as well as many others. Nancy Pelosi said, to know what is in it, your have to read it and they went ahead and passed the Obamacare without even knowing what they were passing. The United States doesn't need to be a NANNY nation just because other nations are Socialist and want the people to be dependant on them. We are Americans and we have a desire to work for what we buy or want to buy. I don't care about other countries, as I told my boys growing up, just because other kids do things, that doesn't mean you can do them also. If you are in Australia, then how can you even feel what pains we are feeling, we are two separate countries. I don't tell Aussies what to do and I would hope Aussies would stay out of our affairs. You don't have a dictator like we are experiencing as he goes around Congress and makes his own rules as he goes.... The American citizens have seen what is happening with other countries and we don't want it. Our doctors are retiring early, Nurses are doing jobs that were once doctors responsibilities and this American wants good health care, not Nanny Care.!!!!

    Rosie Wood
    11/21/2012

    What on earth is wrong with you people? I understand not wanting so much government interference, but why do you not have enough compassion to have a universal health care system? Do you want the United States to remain the only developed nation not to care enough about the welfare of each of its citizens to ensure equal health care as a right for each and every citizen? It makes sense that it is fun federally by the government as it it a national issue. If private enterprise manages it, it must do so for profit, making it more expensive than it need be. This Aussie cannot understand the opposition at all. The United States has the benefit of reviewing all the other government run national health care systems around the world and choosing the best systems of all to set up it's own. It's the decent thing to do.

    Jeremy Martin
    11/21/2012

    Not even that, there is no legal requirement to set up an Obamacare exchange. All the Gov's have to do is say, "Thanks, but no thanks".

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