These Exchanges will NOT be up and running in any form by 2014 let alone being able to offer coverage and pay providers. So if an individual loses their employer health coverage or their employer does not offer coverage and they cannot afford private policies or make too much to qualify for Medicaid they will be without coverage AND then be “fined” on their income tax. Santa Claus has become the Grinch.
If a state does not have an exchange, the mandate does not apply for the employer or individual. The federal exchanges have no mandatory funding mechanism. Resist we much.