The Patient Protection and Affordable Care Act has become so controversial especially because it is deemed unconstitutional that many states are filing a lawsuit against it. If this was written genuinely for the interests of the people then it should have had a fight in the Supreme Court Justices.
However there's a lot of shady transactions and compromise involved. If you want further information with regards to this, you can see it in Article 1, Section 8 of the Constitution.
Federal law falls under the blanket of laws that stretch from sea to shinning sea and must remain equal for all citizens. The Federal Government does not have the ability to initiate and pass laws that are state specific or group specific and this is where the difficulties with the Health Care Reform come into play.
Some of its provisions lean in favor towards only a few states. This is not according to the Commerce Law in our Constitution. It is now up to each state government to decide to participate or not. It will be intriguing to see how each state government will deal with the problem of changes.. Don't forget, that when the dust settled at the end of the War Between the States (Civil War), it was the individual states that assumed power to the Federal Government for the good of a strong, stable Union.
Let's find out how the single payer Health Insurance Reform will unfold. Are they going to add provisions to the law? Will the Republicans win in their call to have it repealed?
What will happen to people who will still refuse to purchase Will these individuals be refused access to other adjoining states? The Health Insurance reform bill is considered to fall under the interstate commerce clause. Only time will be the judge as to how this new health insurance reform will be implemented.