wbcoleman
DP Veteran
- Joined
- Jun 13, 2012
- Messages
- 1,833
- Reaction score
- 431
- Location
- Chicago
- Gender
- Male
- Political Leaning
- Libertarian - Right
States can opt out of the Medicare expansion, though they would be idiotic to do so (because it costs them nothing for three years and only 10% after that). But they cannot avoid exchanges. If they fail to set up their own then state residents will be able to take advantage of a federal exchange.
Everyone knows that the Medicare subsidies are temporary; they are designed to suck the states in. As for the exchanges, mass refusal will tax the Fed's ability to set up dozens of exchanges. Recalcitrant states can't stop the scheme, but they can throw a lot of sand in the gears.