[Brad from Tennessee]

The court ruling didn't kill “medicaid exchanges.” There aren't any Medicaid “exchanges.” It ruled that states could opt out of Medicaid Expansion without having their existing Medicaid systems defunded as penalty.

[ncalburt]

The exchanges are Medicaid based .
The states were being forced to set up bloated programs using the federal coverage standards that was being dictated for Medicaid nation wide .
The courts said that states can still get matching funds for their unique programs .