In states like California and possibly New York and a few others Obamacare is working fine like it was designed to because of State Insurance exchanges where they are properly set up. Where there isn't Medicaid or states where there are no State Insurance exchanges it won't work well or at all.
I think it is likely that the people responsible for exhorbitantly high premiums in those states likely might be voted out of office, if only because of how much money they will cost the people who want their insurance premiums to be lower. So, in order to comply with Obamacare because it is a mandated Federal Law at this point, the people in states who chose not to set up State Insurance exchanges or Medicaid likely will be voted out of office. However, it is possible that some other alternative might be thought up by the local states themselves in order to better comply with the Federal Law.
After all, if Obamacare stays the law of the land it is obvious that people are either going to have to pay 2 o 3 times as much for their insurance as they should or the states will have to change the way they deal with Obamacare, on or the other.
It is fairly likely that Obamacare will stay pretty much the way it is with some of the minor details changed over time to make it more efficient for everyone throughout the 50 states. By keeping what works and changing what doesn't I think 50 years from now people will be equally as happy with Obamacare as they are now with Social Security, Medicare and other such programs here in the U.S.
My neighbor, who is a retired Eye Doctor said to me recently, " Isn't Medicare wonderful?" I agreed with him because you can't beat what you get for either 100 or 200 dollars a month (depending upon your income).
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