Lets see a state can also opt out. Hmm - opt in and create an exchange with Boatloads of Federal money that doesn't exist - We're so broke we have to repay 16 trillion before we are just broke, or we can let the feds do it - and since they have no real money go broke and create yet more massive federal bureaucracy that will be unable to cope with the morass it created.
I'm sure you will love being a Florida citizen, I wonder how many Docs will pick up and leave rather than deal with the federal leviathan? What next - the Federal government mandating some doctors move to Florida and practice medicine? Will they draft med students and force them to serve in order to provide medical services to Florida?
Scott looks plenty smart to me. why burn money the state doesn't have - let the Feds pay entirely for it. The federal government can not force states to pay for anything they administer. The feds can cut funding for exchanges to states and leave them holding the bag - which is exactly what Obama or some future president will do. More states governors should realize the game and let Obama set up the exchanges - all states opt out and leave the Federal Government responsible for it's own mess. Might as well push the country into insolvency earlier rather than later so we we dump this government gone awry and start anew.
Your lack of understandingn,sstail, is amazing. First of all where are the Drs. going to go. Every State will have an exchange. Canada..whoops single payer, Europe, whoops single payer, Latin America, whoops primarily single payer..... Most are going to stay so they get the opportunity to work at some of the newest medical complexes in the US such as Medical City in the I-4 corridor. Next, the only role the Exchange plays is providing a single location for someone to go to select and purchase a benefit plan offered by a private insurer and apply for premium subsidy if he/she qualifies. That private insurer will be doing the premium billing, paying the claims, building their provider networks and negotiating fee schedules with the providers. They will also be doing service authorization or denial of services. Drs. will be dealing with the leviathan insurance companies the way they currently do.
By the way, the leviathan Federal Gov't has a lower administrative costs for Medicare than do the leviathan private insurers for their Medicare Advantage plans.
BTW sstail, since the State of Florida under Rick Scott does not know how to conduct an election, I am personally happy that Rick has decided his administration is too incompetent to manage an exchange.