If you're a state and you don't set up an exchange, that means your citizens don't get their tax credits.
Jonathan GruberWhat's important to remember politically about this, is if youโre a state and you donโt set up an Exchange, that means your citizens donโt get their tax credits. But your citizens still pay the taxes that support this bill. So youโre essentially saying to your citizens, youโre going to pay all the taxes to help all the other states in the country. I hope thatโs a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these Exchanges, and that theyโll do it. But you know, once again, the politics can get ugly around this.
Jonathan Gruber