Gov. LePage, and many other Republican governors, have opted not to set up state-run exchanges for their citizens to use to sign up for health insurance under the Affordable Care Act.

This decision is based in part on advice that doing so would help undermine the implementation of the ACA and hopefully lead to its collapse – especially should the law be interpreted to deny federal subsidies to those who obtain their coverage through federal, rather than state, exchanges.

And these same factions are hoping that the Supreme Court does rule that these subsidies are, in fact, illegal for those citizens who do not obtain health insurance through a state-run exchange.

So more than 13 million Americans would lose their affordable health insurance, and the ACA would presumably collapse under the weight of unaffordable coverage for the majority of families who become ineligible for subsidy support.

And with the collapse of the ACA, issues addressed by that law will go back to Congress, where – despite persistent opposition – there have been no concrete, viable proposals to accomplish the same goals of expanding health care coverage and lowering health care costs for our country.

So we are looking at several more years before any meaningful reform takes place, if ever. And this is a good thing?

Doug Zlatin