The domino effect of Congress’ failure to revise, rework or reject the Affordable Care Act last month has tossed the ball back to the states to figure out how best to deal with their indigent, uninsured residents. And this time, Georgia may have to pick that ball up and run with it. When the law known as “Obamacare” was first passed in 2009, it offered states federal dollars to expand their Medicaid programs to provide health care for the poor.