There Are 50 States in the USA, And People Live in All 50

This seems like a bizarre objection to the Coburn/Ryan/Nunes/Burr health care bill from Cato’s Michael Cannon:

And if Massachusetts created an “exchange” on its own, why do other states need federal legislation?

Presumably because there are fifty states in the United States of America and there are people living in all of them. One of the animating ideas behind the bill is that the Massachusetts “exchange” is a good idea that works well. The purpose of legislation aimed at spurring the creation of more state “exchanges” is that this is a good idea that works well.

For my own part, I have my doubts that the sort of exchange the Coburn/Ryan/Nunes/Burr bill envisions is really adequate. They don’t have enough funds to ensure that people would be able to afford a reasonable plan. Their minimum coverage standards seem inadequate. It’s not really even clear that the bill would create exchanges in all states. And absent a public option, we’re not going to have productive competition that improves quality. But “if it works in one state, why have other states do it?” is an almost self-refuting complaint.