implementation to the feds. that's the choice. but they write there's a third alternative where states set up their own markets for health insurance in a way that he feels would get around a lot of those problems. are there other options here? >> i think there are really two options. there's the one that was mentioned, but also when the supreme court decided that the medicaid expansions were optional, they really dealt the states back into the game on the future of obamacare. they now have the chance to go to the administration and say, yes, you want these expansions, here's what we want. we want greater flexibility in setting up these exchanges, we want some relief from the regulatory burden. we don't want insurance products to be turned down by health and human services. so the more states can get in the business of generating flexibility, setting up their own exchanges and using them for better competition and choice, the percent off the end game will be. patti ann: all right, douglas holtz-eakin, thanks for joining us.

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