Water-Bug wrote:
So the ACA has no effect in MA ????
The ACA impacts every state and DC - the impact upon US territories is different - Congress made one part of the law - the ACA apply to the territories, but the other part of the program - the amendment to the Public Health Act which requires insurance companies to accept all applicants and the individual mandate - does not apply to territories.
Massachusetts is one of 16 states (& DC) which are not part of healthcare.gov. They setup their own exchanges and manage their own system. (HI, WA, OR, CA, ID, NV, CO, NM, MN, KY, MD, NY, VT, CT, RI, MA - run their own system.) UT has a hybrid system - state run for small businesses and federal for individuals).
IA, IL, AR, WV & NH plan to be part of a multi-state Marketplace/ Exchange.
The other states chose to require their citizens to use the federal system.