The voters have ensured that ObamaCare will now move forward. Close to 33% of states have refused to set up health insurance exchanges, and a similar number is contemplating the refusal of Medicaid expansion. If Obamacare fails, it will not open the door for reconsideration of alternative reforms advocated by the Republican opposition. The refusal to advance the ObamaCare implementation at the state level will not generate a sincere discussion of meaningful compromises by this Administration. The reality is that President Obama and the Democrats' fallback plan for ObamaCare's failure is fully nationalized, single payer healthcare.