When the law allows for opting in or opting out, and states can choose between the two, and they choose to opt out of creating exchanges, how is that "holding back?" They are exercising their legal rights that were legislated by their representatives in Congress.
The same can be said for Article V conventions. If the states have two paths to control the federal government, sending politicians to Congress who can vote for amendments or convening a convention of the states to propose their own amendments, and the states choose to convene to propose their own, is that "holding back" (or the real word they wanted to use "undermining") the federal government?
Do people really expect us to follow some unwritten rule that certain "negotiated" or "compromise" amendments are added to bill, but we're not supposed to actually use them later on? They are only there for show, for the political expediency of getting the bill passed, but that nobody really expected anyone to actually want to DO it? And that we will delegitimize anyone who tries to?
-PJ
It was pointed out how this could be done three years ago when the text of the bill was analyzed at findlaw. And that is just one of many different ways the fangs have been pulled.
If you live in one of these states, you should be explaining this to people around you. Particularly young healthy people.
Democrats should have read their own bill so they would have known what was in it. Fortunately an army of lawyers stepped up to read it. The main thing to keep crippling it now is for state attorney generals to continue to not allow Obama to try to rewrite the law through executive orders.