Obamacare is Single Payer with a time delay

[TheKentuckian]

116. No they won't. They are governors on the engine to limit the speed and consumption, at best.

That is assuming great implication, newly empowered state regulators from nowhere resource wise, and that the penalties and limitations are meaningful and practically enforceable.

There is also (assuming the best intent and wisest design) the baked into the cake assumption the the insurance industry is a rational group of competing businesses looking to turn an honest buck in exchange for value added services that benefits the broad population doing business in a rational market rather than a predatory cartel that rules an irrational and therefore immoral miking scheme, none of which is true.

The state by state single payer path is a glimmer of hope or better but it has handcuffs too and has a better than serious chance of actually being limited to too small a proportion of the population to mean much. Subsidized access to the exchanges is pretty strictly limited which is likely to only impact the populations in them which means they will operate as little test labs with highly distorted samples to compare and contrast. This means your time line is longer than implied, even if it goes exactly as hoped with no or only minor set backs.

You are also assuming that states will generally act and function substantially differently without budgets and regulatory tools to support such a turning of the leaf and that corporate capture is inherently diminished.