Ponnuru writing at Bloomberg - read the whole thing.
Obama’s plan makes tax credits available to people who
get health insurance from exchanges set up by state
governments. If states don’t establish those exchanges, the
federal government will do so for them. The federal
exchanges, however, don’t come with tax credits: The law
authorizes credits only for people who get insurance from
state-established exchanges. And that creates some problems
the administration didn’t foresee, and now hopes to wish
away.
Many states are determined in
their opposition, and few of them have set up exchanges. If
they don’t do so, the tax credits don’t go into effect and
the federally established exchanges won’t work: People
won’t be able to afford the insurance available on them
without the subsidy.
States have another incentive to refrain from setting
up exchanges under the health-care law: It protects
companies and individuals in the state from tax increases.
The law introduces penalties of as much as $3,000 per
employee for firms that don’t provide insurance -- but only
if an employee is getting coverage with the help of a tax
credit. No state exchanges means no tax credits and thus no
employer penalties. The law also notoriously penalizes many
people for not buying insurance. In some cases, being
eligible for a tax credit and still not buying insurance
subjects you to the penalty. So, again, no state exchange
means no tax credit and thus fewer people hit by the
penalty.
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