I'm not sure what your statement meant, but the states will run there own Health insurance exchanges unless an a-hole like Gov Scott of Florida refuses to do it, in which case the federal gov will take over that function.
Understand we are not talking about a new system here. All we are doing is making a broken system a little less broken. Yes, there are some new guidelines and the IM but for the most part this will really only affect people who have no insurance.
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