IRT AirSumo, Mitt Romney?  You jest.  What part of ACA was Mitt Romney's?  And, why there were not one vote from a Republican in the House and Senate if Mitt Romney had a part of ACA.  No make sense.  On State control, Hawaii is one of the best States for patients with pre-existing conditions, such as you have.  The State of Hawaii is controlled by the Democrats and they will fight to the death to protect supporters as you and others with catastrophic ailments.  I believe it's a huge advantage for Hawaii citizens in your kind of situation to have the State control your healthcare, as was prior to ACA.