I didn't go to law school; It took several passes to figure this article out. I'm sure that's a sign that ACA will run smoothly. In any case Hugh, you just don't seem to understand how this regime works. They will either bully their way into forcing exchanges on the states, or they will toss out temporary waivers like candy at a parade to get the bulk of people on board. The entitlement people of the pariah states will demand their free stuff. You lose. We all lose.