The problem will be the masses of folks who will riot because they want their free health care.
Thats only a problem for those unwilling to deal effectively with those kinds of people.
This is why the states that want to be free just need to inform their citizens that they are going to adopt the model of a free state and people unbound from the tyranny of socialism / marxism. Then offer to move them and their things to the slave state of their choice, free of charge, if they feel they just cant handle being responsible for themselves and their wellbeing. Make the offer expire after 3 months or something along those lines.