Arizona and Michigan have joined the list of states refusing to establish health insurance “exchanges.” These “exchanges” are the devices used to implement the Individual Mandate; although they’re supposed to look enough like actual markets to fool people, in reality they are nothing like an actual market. You’re forced to buy a product which insurance companies are forced to sell you, and the contents of which are dictated by the federal government; not exactly what “exchange” normally means. States are not, of course, required to establish these “exchanges.” The law says that if states don’t do it, the federal government will do it. And if the states do do it, state taxpayers get socked with major tax consequences. (Although the federal government has tried to change that last part, the way it did so is illegal, and is currently the subject of a lawsuit pending in Oklahoma.) What’s more, state exchanges are illegal in those states that have adopted Health Care Freedom Acts. But not only are state exchanges expensive and burdensome for taxpayers and already illegal in many states, but if states refuse to collaborate with the federal takeover of health insurance, the federal government doesn’t have the resources to set up its own implementation scheme. That means that state resistance will help to built support for real, market-based reform of the health insurance market–as well as buying time for the ongoing litigation challenging various aspects of Obamacare. Meanwhile, new polls show that 54 percent of Americans regard the PPACA unfavorably, including a majority opposing “universal coverage.” The founding fathers created our federal system precisely so that states could help shield us against federal overreach, and state officials are using their constitutional tools to protect Americans from a law that most citizens have always thought wrongheaded. So thanks again, Mr. Madison!