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The single state blues will hop on board as I'm sure the state gov't is in discussions with and will get buy in from a carrier before proceeding.
I would hope that any sensible state politician or DOI person would get buy in from the local/state dominant carrier (blues for ex), and create the framework TOGETHER before proceeding.
Here is a detailed article on the topic. Seems like a practical approach in some areas:
https://www.healthaffairs.org/do/10.1377/hblog20180126.6620/full/
plan made up of men, age 26-49
You got a problem with younger men?