I'd like to send this to mgmedical.ro The main reason, he said, is that the money flowing to the16 states and the nation's capital that are running their ownACA exchange is what's called a "permanent appropriation,"enshrined in the 2010 healthcare reform law. Because the fundsare not subject to annual appropriations, they will continue tobe available to states that need to pay employees andcontractors and buy equipment and supplies.