1) If a State doesn't set up an exchange and HHS does, can the State change their mind and create their own exchange say in 2016?I believe they can. 2) If a State does set up an exchange and realizes they can't handle the additional financial burden can they end the exchange and allow HHS to run it?I haven't heard of this. I think the expectation was that states would handle this themselves. It's difficult for HHS to set these up because each state has their own insurance regulations so it's not a one size fits all. I would venture to say that once a state has an exchange, they own it. Given that the GOP position themselves with states rights, I would expect that GOP governors would prefer to run their own. Instead, they're going against what they stand for in some futile attempt to fight a law that's been ratified by SCOTUS. State might find out it's better to join after other States set up good examples or leave if they can't handle it. States that have laid the ground work for exchanges have offered up their work. It's there if they want it. Grape
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