The States with a majority of Sex Deviates, Criminals, inner-city tribes, and illegals would want OTHERS to continue funding their lifestyles (aka; the Blue States).
The Red States, home of self-reliance, morallity, and common sense, would opt to be free of Government over-reach, and wealth redistribution.
The problem is that in the Red States, the large cities are infested with tribal parasites who are generating numbers of dependents who vote straight (D), and names are used for vote Fraud as a way of life.
The ACA is remarkably, financially fragile. All it will take is 8-10 states to opt out and the whole thing collapses in on itself.