The fate of Obamacare will be decided in the next few months. States like Arizona will play a critical role. Governor Brewer and the Legislature have to decide whether or not to get on the Obamacare bandwagon by establishing a “medical insurance exchange” or whether to join the resistance and refuse to cooperate.   That sounds like a tough decision but it really isn’t, the way the law is written. In exchange is a government created marketplace where citizens hoping to avoid the penalty, er, tax for not buying insurance can go to purchase an approved policy. All insurance products on the exchange will include the federal and state mandates and any premium subsidies that may apply. If Arizona doesn’t establish an exchange, the feds will.   Advocates claim we would be better off having control of our own exchange so we can write the rules in an Arizona friendly way. That sounds plausible, but under the law, Arizona could only add to the federally mandated benefits and subsidies. We wouldn’t be permitted to reduce any regulation we thought wasn’t helpful. So our control could work in only one direction – to make healthcare even more expensive and highly regulated.   Then there is the matter of cost. Gov. Brewer already designated $30 million for planning and development but the feds promised to pick up the expenses for operating the exchange. But wait, that’s just for the first three years, then we are on our own. You know what that means.   Medical insurance companies are all for the exchange because they will be able to exert more control at the state level. But Arizona would be better off financially bypassing.   Gov. Brewer and our legislators need to recognize, like other states already have, that you can’t be on the Repeal and Replace team while also going along with Obamacare.  It’s time for choosing.