"[O]ne reason the law is so complicated is that it created a raft of incentives to encourage health insurers, hospitals and other powerful constituencies to buy into its goals. That raft will now help keep the law afloat...Unless the exchanges for individual insurance policies prove to be a complete disaster -- with only the old and sick signing up for policies -- they will gradually add another pontoon to support the law. There is some evidence from up-and-running state exchanges that they may actually turn out to be, over time, a modest success. Who will sponsor the legislation to cast those consumers back into the world of pre-existing conditions and arbitrary cancellations of policies? Meanwhile, millions of people not living in states where ideology has bludgeoned humaneness into a political pulp will be added to Medicaid rolls. Who will champion the plan to eliminate their insurance?" Francis Wilkinson in Bloomberg