States can and should help end Obamacare whether Congress does its job, or not.

Will Republicans in Congress actually send Pres. Trump a bill to repeal Obamacare?

At this point, it seems highly unlikely. The changes to the ACA proposed by the U.S. House and Senate keep the basic the framework of Obamacare in place. It’s not even repeal and replace. It’s more like tinker around the edges and keep it in place. So far, the Republican-controlled Congress hasn’t shown any signs of being able to get even these modest “reforms” passed.

In light of Congress’ apparent ineptitude, it’s important to note states can take action right now that will set the stage to bring the Affordable Care Act down, no matter what Congress does.


By refusing to provide any state or local cooperation with the implementation or administration of Obamacare – or whatever version of national healthcare Republicans create.

The ACA was predicated on state cooperation. Any Republican “replacement” will be as well. By ending all state actions that support the ACA and refusing to enforce any of its mandates, a state can make it nearly impossible to run Obamacare within its borders.

The federal government never intended to run the healthcare system alone, and ultimately, it can’t do it without state help. It even tried to compel states to expand Medicaid under the act, but that portion was struck down in the famous “Obamacare case,” NFIB v. Sebelius.

Additionally, we’ve seen the difficulties created for the Act by the number of states that simply refused to set up exchanges for the federal government.


Refusing to expand Medicaid or set up an exchange are two essential steps states should take. West Virginia took the first step in the last legislative session, scrapping its state-run insurance exchange.This will force the feds to run the exchange themselves, and will just increase the strain and burden on federal resources.

But states can go even further. Judge Andrew Napolitano noted that if a number of states were to refuse to participate with the ACA in a wholesale fashion, that multi-state action would “gut Obamacare.”

Napolitano said that if enough states follow suit, “it will gut ObamaCare because the federal government does not have the resources or the wherewithal […] to go into each of the individual states.”

States can pass legislation to completely end any and all state participation in the Affordable Care Act (or any other national healthcare scheme). Here is an example of some simple model language that would effectively shut down all management and implementation of the ACA in a state.

That the general statutes be amended to repeal all statutes implementing health care mandates required under the Affordable Care Act, prohibit the state from participating in any program under or appropriating or expending any moneys in furtherance of said act, and dissolve all programs related to said act.

“The federal government can barely manage running a website,” Tenth Amendment Center Executive Director Michael Boldin said, noting that this kind of legislation would ban a state’s department of Insurance from investigating or enforcing violations of federally mandated health insurance requirements. He said this would “prove particularly problematic for the federal governmen