A. Barton Hinkle on Virginia's Response to Obamacare

If states don't create a health care exchange, then the federal government will step in and do it for them. This has led many Republicans to believe, erroneously, that they have a choice between having an exchange built to their liking—perhaps one that offers flexibility and a remnant or two of free-market economics—or a costly, bureaucratic blanket of regulatory excess. But that's not the choice at all, writes A. Barton Hinkle, because any state exchange must receive federal approval, and the Department of Health and Human Services has written hundreds of pages of rules that must be met to win such approval.