If and when licensure is tied to Medicare/Medicaid participation, then our choices will be reduced.
Meanwhile, I prefer to see these (MU, PQRS, etc) as incentives rather than requirements. So we get to make the call: is the time and energy to participate in these programs worth the financial return or not? Do we think they will improve the quality of care we deliver or not? It is still OUR decision.
As Jim says above, "the AC user has the ability to extricate himself from MU/PQRS if it is in his best financial interest to do so".