We have Congress, a ready and willing President, and the most blatant mandate imaginable. Obamacare was the beginning of the erosion of Democrat power in the United States. It is a horrible law, which hurts 2 people for every person it helps.
All the Exchanges ever did was make available policies that the fucking Blue States would not allow ordinary carriers to provide. They made individual policies available, where otherwise the options were COBRA or having a job with insurance.
Now, a lot of Obamacare, since it was a left wing creation, consists in subsides the rest of us pay–or which the government borrows on behalf of our children–and much more consisted in raising the amount of household income a family could make and still get Medicaid, but all this could be retained for a period of 2-3 years while people start self insuring on high deductible policies which we can still subsidize into the future.
There is something inherently better when people have skin in the game, which is what happens when you write checks to insurance companies, versus walking into government offices filled with slow moving fat people and demanding they give you things you deserve because you were born, and haven’t done much with your life.