[capydick]

There are parts of this though that are not up to the States, unfortunately.

Although not as big a deal as the individual mandate, one nugget tucked into this monstrosity is the change in FSA (Flexible Savings (Spending) Accounts). If your employer offers one of these, you now need a prescription from your doctor to receive OTC medicines for allergy, heartburn, children's cough medicine, etc. It's ridiculous and a hassle and all FSA providers / employers have to abide by the rule when applying for reimbursement. The net effect is to drive people away from these plans and make it as hard as possible to use.

[Springfield Reformer]

If it happens in a state, the state has a say in how it gets enforced. Witness Texas and other states refusing EPA and other fed regs, and even threatening arrest of fed enforcers, on a belief that fed jurisdiction is finite after all and can be countered on a Tenth Amendment or other constitutional basis without prior approval from SCOTUS. I believe any portion of Obamacare being implemented anywhere within a state's jurisdiction could be deflected indefinitely if the governor had the political will to do so.