Federal Health Insurance

Attached a link to an article titled " Most Governors Refuse to Set Up Health Exchanges" reporting that as of Friday, December 14th, more than half the states (including Florida) had rejected the Obama administrations pleas to set up their own health insurance exchanges. The exchanges are online market places where people can shop for private health insurance and obtain federal subsidies to help defray the cost. The Congressional Budget Office has estimated that in 2014 about 25 million people will eventually receive coverage through the exchanges. A total of 32 states that haven't agreed to set up their own insurance exchange could present the biggest challenge to fulfilling the law's requirement. In all, around 197 million people live in states that have chosen not to run their own exchanges. Of those people, about 18.3 million are uninsured and have incomes that could qualify them for subsidies if they bought policies through the exchanges.Federal officials and federal contractors will set up and run the exchange in any state that is unable or unwilling to do so. In my opinion the states refusal to set up their own exchanges will preclude those states to address specific insurance and demographic issues. A federal "off-the shelf" solution may not be sufficient to meet those specific requirements. The losers will be those uninsured who are forced to buy what the federal market place can offer. On the other hand, as a single payer advocate I also foresee that a consolidated federal market place may offer a first step for a national health insurance. So may be I should send a thank you note to Governor Scott. Yours Bernd