If your state is run by one of those Republican governors who is still refusing to participate in any way in the implementation of the Affordable Care Act’s state-level health insurance exchanges, here’s what you need to know: not participating makes the implementation more expensive, not less; not participating surrenders state control to the federal government, not the other way around. If your governor is refusing to participate in the creation of your state’s health insurance exchange, your governor is sabotaging your state’s sovereignty in service of a pointless ideological tantrum.
And that matters, to you, whether you know it or not.
Some states will have real market reform, and the state-level authorities will be actively involved in that reform, representing their constituents and steering the process of reform in a way that is most affordable, and helpful, given the lay of the land and the unique circumstances people face in communities across that state. This cannot be said of those states where ideologically captive governors abdicate their responsibility and invite the federal government to do all of the heavy lifting.