Insur­ance car­ri­ers are dis­mayed  that the indi­vid­ual man­date is being repealed for the sim­ple rea­son that the abil­i­ty of indi­vid­u­als to opt out of cov­er­age will cause a neg­a­tive spi­ral in health care costs, as the pool of cov­ered peo­ple devolve into those who are more in need of ser­vices.  Some states, how­ev­er, includ­ing Cal­i­for­nia, are fight­ing back and con­sid­er­ing a state man­dat­ed man­date. We shall see.