The employers will accept the penalty over insurance. But the states w/o a penalty will be better than states with a penalty. This will be like right to work vs forced unionization. Pretty much all the jobs created in the so called recovery have been in right to work states. The economic conditions between red states and blue states will grow; that’s good.
Eventually, there will be no private health insurers and all health care will be nationalized.
Some private facilities may remain for up front fees. The good stuff will be off shore.
Don't forget, socialists hate free enterprise, profit and private property. There is still plenty to be confiscated.
Might as well add rule of law to that list.