It's either Hosni Mubarak or a bunch of people who will be enemies of yours.

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The decision, however, is yours and I hope the thoughts I have expressed will be of help to you in reaching it.

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But if it means more states like yours will share the responsibility of administering insurance exchanges, perhaps this is a concession Washington would be willing to consider, especially given likely implementation challenges associated with setting up a larger-than-expected national exchange within very tight timelines.

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