<story><title>The ten year anniversary of the Healthcare.gov rescue</title><url>https://www.pauladamsmith.com/blog/2023/10/the-10-year-anniversary-of-the-healthcare.gov-rescue.html</url></story><parent_chain><item><author>mlinhares</author><text>If I was running a state agency and the federal government told me I could just use their system instead of spending my own money I would definitely take on the federal government instead of paying for it. Sometimes the whole &amp;quot;states are their own thing&amp;quot; here in the US goes way too far.</text></item><item><author>PopAlongKid</author><text>For context, the original intention was that states would run their own exchanges, only if they refused would residents of the state use the federal exchange.&lt;p&gt;36 states initially did not set up their own exchanges.[0]&lt;p&gt;It appears that currently, 20 states (including D.C.) have their own marketplace.[1]&lt;p&gt;&amp;gt;The shutdown prevented anyone from outside the main team working on HealthCare.gov from coming in to help&lt;p&gt;That government shutdown in 2013 was instigated entirely by one U.S. Senator, Ted Cruz, expressly for the purpose of sabotaging ACA.[2]&lt;p&gt;[0]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;aspe.hhs.gov&amp;#x2F;reports&amp;#x2F;health-insurance-marketplace-premiums-2014-september-2013&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;aspe.hhs.gov&amp;#x2F;reports&amp;#x2F;health-insurance-marketplace-pr...&lt;/a&gt;&lt;p&gt;[1]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.healthcare.gov&amp;#x2F;marketplace-in-your-state&amp;#x2F;&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.healthcare.gov&amp;#x2F;marketplace-in-your-state&amp;#x2F;&lt;/a&gt;&lt;p&gt;[2]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.texastribune.org&amp;#x2F;2016&amp;#x2F;02&amp;#x2F;16&amp;#x2F;ted-cruz-2013-obamacare-shutdown-was-defining-mome&amp;#x2F;&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.texastribune.org&amp;#x2F;2016&amp;#x2F;02&amp;#x2F;16&amp;#x2F;ted-cruz-2013-obamac...&lt;/a&gt;</text></item></parent_chain><comment><author>liveoneggs</author><text>Would you also take federal money to expand medicaid coverage to the poor citizens of your state?&lt;p&gt;If so you might not be qualified to be a republican governor.&lt;p&gt;Wouldn&amp;#x27;t it be much better to hire your friends as IT consultants, make broken systems as confusing as possible, and continuously change the rules, and then starve the half-assed system of funding in an attempt to keep people from signing up for coverage at all?  What makes this plan doubly republican-friendly is that all players are your donors and most victims are minorities.</text></comment>
<story><title>The ten year anniversary of the Healthcare.gov rescue</title><url>https://www.pauladamsmith.com/blog/2023/10/the-10-year-anniversary-of-the-healthcare.gov-rescue.html</url></story><parent_chain><item><author>mlinhares</author><text>If I was running a state agency and the federal government told me I could just use their system instead of spending my own money I would definitely take on the federal government instead of paying for it. Sometimes the whole &amp;quot;states are their own thing&amp;quot; here in the US goes way too far.</text></item><item><author>PopAlongKid</author><text>For context, the original intention was that states would run their own exchanges, only if they refused would residents of the state use the federal exchange.&lt;p&gt;36 states initially did not set up their own exchanges.[0]&lt;p&gt;It appears that currently, 20 states (including D.C.) have their own marketplace.[1]&lt;p&gt;&amp;gt;The shutdown prevented anyone from outside the main team working on HealthCare.gov from coming in to help&lt;p&gt;That government shutdown in 2013 was instigated entirely by one U.S. Senator, Ted Cruz, expressly for the purpose of sabotaging ACA.[2]&lt;p&gt;[0]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;aspe.hhs.gov&amp;#x2F;reports&amp;#x2F;health-insurance-marketplace-premiums-2014-september-2013&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;aspe.hhs.gov&amp;#x2F;reports&amp;#x2F;health-insurance-marketplace-pr...&lt;/a&gt;&lt;p&gt;[1]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.healthcare.gov&amp;#x2F;marketplace-in-your-state&amp;#x2F;&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.healthcare.gov&amp;#x2F;marketplace-in-your-state&amp;#x2F;&lt;/a&gt;&lt;p&gt;[2]&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.texastribune.org&amp;#x2F;2016&amp;#x2F;02&amp;#x2F;16&amp;#x2F;ted-cruz-2013-obamacare-shutdown-was-defining-mome&amp;#x2F;&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.texastribune.org&amp;#x2F;2016&amp;#x2F;02&amp;#x2F;16&amp;#x2F;ted-cruz-2013-obamac...&lt;/a&gt;</text></item></parent_chain><comment><author>ceejayoz</author><text>In many cases, it was ideological, not fiscal.&lt;p&gt;States opting not to open their own exchange (grey): &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;HealthCare.gov#&amp;#x2F;media&amp;#x2F;File:ACA_health_insurance_exchanges_by_state.svg&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;HealthCare.gov#&amp;#x2F;media&amp;#x2F;File:ACA...&lt;/a&gt;&lt;p&gt;States opting not to expand Medicaid (blue): &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;upload.wikimedia.org&amp;#x2F;wikipedia&amp;#x2F;commons&amp;#x2F;4&amp;#x2F;47&amp;#x2F;Medicaid_expansion_map_of_US._Affordable_Care_Act.svg&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;upload.wikimedia.org&amp;#x2F;wikipedia&amp;#x2F;commons&amp;#x2F;4&amp;#x2F;47&amp;#x2F;Medicaid...&lt;/a&gt;&lt;p&gt;(The second chart had more blue at the time; opt-outs have gone from 26 down to 10 now.)</text></comment>