for dismissing an article. I think that's childish, unless that dating actually makes a fundamental difference in the situation, which in most cases, like the first article you posted, it doesn't.

But I'm not sure either really answers the question (or supports the "sabotage" claim in the second article). I still see nothing that explains why a person would be any better or worse off in the exact same living scenario based on whether they use the Fed or a State run exchange. Instead, both seem more to draw conclusions about different state's populations, and then try to causally tie those to Medicaid expansion or lack thereof, and hoo runs the exchange. Even if the causal link makes little sense.

For example, they talk about non-expansion states having higher uninsured rates and less access (presumably internet, etc.) to their exchanges. I'm not sure how that changes based on hoo runs the exchange. Wouldn't that be more do the actual wealth, education, and internet access of folks in those states compared to expansion states?

There is certainly some logic to saying not expanding puts more of those poor and less healthy people into the exchange pools (one of the biggest problems with ACA IMO but that's an entirely different topic), but again, that seems more a function of comparing the populations of those states to expanding states, rather than a result of not expanding. Poorer states are going to have more unhealthy people in their exchange pools than a state like MA. Furthermore heavily populated and concentrated states like CA will have more providers and access to healthcare to allow for more competition to keep insurance costs down. And finally you're comparing wealthier, higher income populations to poorer ones. So of course someone in MA can better afford the premium than can someone in GA to keep their uninsured rates down, which only gets multiplied when GA also has higher premiums. And those wealthier states will have a lower % of their population eligible for expanded Medicaid, making it less costly to expand when Fed payouts go down, and less risky when those payouts may disappear in whole or in part after 2020 to impact the Fed budget deficit. So again, I'm not sure how hoo runs the exchange makes a difference here, nor, other than minimally, how Medicaid expansion makes much impact on premium rates when compared to population's wealth and availability of providers.

They themselves acknowledge the flaws in their causal links by pointing out that a) Appalachia will still be more poor and therefore less healthy regardless of what you do, and b) Arizona shows the impacts may not have a thing to do with Medicaid expansion. Makes sense since it logically is causally linked more to availability of providers and wealth of the customers.