Today -- for the 33rd time -- House Republicans are voting to repeal President Obama's Affordable Care Act, with no chance that the Senate will go along. The House and Senate wrangling is political theater while the real action takes place in the states. Texas and Florida are rejecting billions of federal dollars, rather than expanding Medicaid for the uninsured. Washington State has begun implementation. The US Supreme Court created the opportunity for different approaches, so election-year politics may be the ultimate "decider." We hear about the rhetoric, the multiple realities and the potential consequences for 50 million Americans who don't have health insurance.