Mechanic is mostly right, though, D PB. States that have refused federal funds, like WI, have exchanges that are being set up by the Feds and those exchanges are horribly behind and underfunded. But unlike Mechanic, I have a different approach: What this tells me is that the federal government was trying to force something on the states that the federal government wasn’t capable of creating, and was dumping it on the state. Making a federal decision a state burden. This tells me that the PPACA was never a truly viable option. Mechanic, the reason Republicans are against this program is because they have looked 10 years down the road and don’t like what they see. When federal funding for Medicaid/care support wears off, the states are going to be left with a massive financial burden. I will remind you that this financial burden is something like 54% of this country doesn’t want (i.e. that’s how many do not support the PPACA and want to see it removed). So in all reality, the Governors of these states that are saying, “no,” to the federal funds are obeying their people’s will… something Governors are required to do. Being a taxpayer in WI, I approve of Walker’s actions, and every other Governor who says, “No,” to this program.The federal government tried to mandate that states take their porridge and like it, but the SCOTUS said that exceeds their Constitutional authority. It’s for this exact reason.