As the Michigan Legislature wrestles with Gov. Rick Snyder's call to create the architecture of a state Obamacare health insurance "exchange," Mackinac Center adjunct scholar John Graham observes in The Health Care Blog: "The likelihood of exchanges being up and running by January 2014 is vanishingly close to zero. Indeed, they may not exist at all except in very few states — whether or not President Obama wins re-election."

Among the evidence Graham cites is the recent refusal of the Republican-controlled New York state Senate to advance legislation creating an exchange, reported here a couple weeks ago: "If they can’t get a PPACA exchange up and running in New York, of all places, where the heck will they? Only 13 states have passed pro-exchange legislation (and some of these bills don’t do much more than establish study groups)."

Among other potential roadblocks, Graham also notes two recently discovered flaws in the Patient Protection and Affordable Care Act that debunk the dread alternative to creating a state exchange — the threat that if states don't Big Mother will come in and do it for them. Read the rest with details here.

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