The complicit states with their "exchanges" are feckless pawns, who are forcing needless suffering and even death on their citizens (See: oppression, tyranny)
The surviving insurance carriers are like Stockholm Syndrome hostages. The QMC (queer/moslem/communist) will use them up until they are broke and no longer useful.....and then murder them.
Obamacare has devolved into a system where most go to medicaid some get very low premiums others very high, all get high deductables and in the end very few doctors even want to take anyone who has obamcare insurance.
Its the perfect tool for medical chaos.