There is no real incentive to make Obamacare work
It is still a terrible law that is making a hash out of the economy. People are either being laid off or given reduced hours to avoid the awful consequences of complying with it. Obama has lost leverage with the states after the Supreme Court said he could not withhold Medicaid funding. By refusing to set up the exchanges the states are forcing the feds to do so, yet they aren't eligible for the subsidies built into the program. Obama may show his contempt for the rule of law and push on, but Congress still has a say in how money is being spent. I still see no reason for states to scramble.
After years of political and legal threats that kept President Obama’s health care law in a state of uncertainty, his re-election all but assures it will survive. The next hurdle is making it work.