ObamaCare and Federal Health Exchanges: Undermining State Flexibility

“The top-down federal approach to health care reform assaults the traditional state role in insurance regulation, squashes innovation, and undermines real choice and competition. PPACA is thus a bad deal for states, reducing them to mere agents of federal health and insurance policy. They could not make full use of their comparative advantages in coping with very different insurance markets, mending the safety net care for the poorest and most vulnerable of their citizens with new policies, or undertaking imaginative reforms without getting a permission slip from Washington.”