Let's assume you're right and it's wildly inefficient. three questions come to mind.1 - Why do you think the Federal Government's plan would be more efficient? The Federal Government isn't exactly the model of efficiency.2 - What if a State has a "better" plan? Should they be allowed to get a waiver? Why is the Federal Government holding back the States?3 - Why do you think one size fits all is a good thing? The best plan for a State like Delaware might not work in Idaho. Just because 50 plans would be inefficent, doesn't mean one Federal one wouldn't be a disaster either.
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