I just came up with an idea for a work-around for the states trying to undermine the implementation of the Affordable Care Act by refusing to implement the Healthcare Exchanges and accept Federal dollars to expand their Medicaid programs to include more people.
It came to me tonight after reading about South Carolina threatening to criminalize people who attempt to implement the Exchanges. I doubt they will be able to pull off their threat.
As the Federal government implements these Exchanges in these states refusing to participate the Federal Government can create a "Federal Medicaid" type program to cover them. The Fed could provide for those people these States would have been required to with the expanded Medicaid funds. You can use the website and network created for the Exchanges to manage and implement the program.
Such a program could be implemented and administered as an "offshoot of Medicare" and funded using the extra Medicaid monies refused by the individual states. If you don't want to incorporate it in Medicare then you can, as an alternative, use the companies listed in the Exchanges and fund through them.
Either way you expand the base of covered individuals and help the poor. Not to mention how medical institutions will benefit by more people having insurance.
It has been said that the states refusing o implement the Exchanges might lead the way to a nationwide single payer system. :)
If they are going to throw this money back into the Fed then lets let the Fed use it to help the poor in these state. Statistics show that the states refusing the aid are among the most neediest and their healthcare the worst.
"I like it when a plan comes together"
Hannibal Smith "The A-Team"