The original intent of President Obama’s Affordable Care Act (ACA) was to establish 50 state exchanges run by the 50 states themselves — the federal exchange was always meant to be a temporary fallback. Instead, 36 states currently rely upon the federal Healthcare.gov — and only two states, Maryland and Oregon, are fighting to get out acheter viagra bon marche.
Observers have noted, correctly, that this shift to a bigger and ostensibly more permanent federally-run system is underway — without debate, study or even funding. There are now more questions than answers about the long term future of the Washington-controlled system.
As pointed out by Politico, the primary reason this situation has occurred is due to “intransigent Republicans shunning state exchanges, and ambitious Democrats bungling them.” It is indeed ironic that Martin O’Malley in Maryland and John Kitzhaber in Oregon — two proud, overtly progressive governors — have botched their state exchanges as badly as they have.
All of this, of course, is yet another demonstration of how dysfunctional governance permeates the landscape both federally and at the state level.
Gordon Hensley