www.thinkprogress.org/health/2014/01/31/3231861/states-failing-obamacare/
"Most states are tackling at least one of the ACA’s three major components: enforcing its market reforms and consumer protections, establishing a state-run insurance marketplace, and agreeing to its optional Medicaid expansion. Seven states have taken charge of all three. However, the researchers write, “[a]t the other end, five states — Alabama, Missouri, Oklahoma, Texas, and Wyoming — declined to play a role in implementing the law’s three major components. These states will not enforce the market reforms, will have a federally facilitated marketplace where the state will play no formal role, and declined to expand Medicaid.”
These five states’ decision not to run their own marketplaces isn’t uncommon, considering that 36 states have defaulted to a federal exchange. Rejecting the Medicaid expansion is somewhat more rare, since 26 states and the District of Columbia have already opted for it and several others could still do so in 2014. But the fact that these states won’t even oversee basic consumer protections and reforms through local regulatory agencies suggests a desire to be a total dead-end when it comes to health reform."
