“While other Republican governors are starting to back away from their opposition to implementing a key part of President Obama’s health care law, Louisiana Gov. Bobby Jindal said Tuesday that he’s not reconsidering.”

“Immediately after the presidential election, and more than a week ahead of the Nov. 16 deadline, Missouri Gov. Jay Nixon, a Democrat, announced he had made up his mind. The state would not be setting up its own health insurance exchange. Next door in Kansas, Gov. Sam Brownback, a Republican, made a similar announcement.”

“The Obama administration said Thursday it will give states an extra month to decide whether they plan to implement the core piece of President Obama’s healthcare law. States were initially supposed to decide by Friday whether they would run their own insurance exchanges. But on the eve of that deadline, HHS told Republican governors they could have until Dec. 14 to make that call.”

“Another Republican governor on Tuesday formally refused to set up an insurance exchange under President Obama’s healthcare law. Alabama Gov. Robert Bentley said the state will not establish an exchange and also will not participate in the law’s Medicaid expansion.”

“While the future of the 2010 health care law stabilized with the re-election of President Obama, both Democrats and Republicans say now is the time for them to come together to fix it… Until Tuesday, when Obama’s future was determined, Republicans opposed to the law waited for a change in administrations that would allow them to repeal the law. That will not happen now with a Democrat in the White House for the next four years… But changes are imminent.”

“The Democrats do not have supermajority control of the House and Senate, as they did in the 111th Congress when the PPACA was passed. Indeed, in 2013 and 2014, Republicans will have a rather sizeable majority in the House, along with 45 votes in the Senate. In addition, there are now 30 Republican Governors in the states, who will have much to say about health care policy in the coming years, too. So, unlike the birth of the PPACA, its implementation will proceed at a time when Republicans are controlling many levers of power.”

“President Obama has won reelection, and his administration has asked state officials to decide by Friday, November 16, whether their state will create one of Obamacare’s health-insurance ‘exchanges.’ States also have to decide whether to implement the law’s massive expansion of Medicaid. The correct answer to both questions remains a resounding no.”

“By the end of this week, states must decide whether they will build a health-insurance exchange or leave the task to the federal government. The question is, with as many as 17 states expected to leave it to the feds, can the Obama administration handle the workload.”

“Voters in Missouri approved a measure Tuesday that will hamper its governor’s ability to implement President Obama’s healthcare law. The law will prohibit the governor from creating an insurance exchange unless the move is authorized by the state legislature or by a ballot initiative. Given the makeup of the statehouse, the measure’s approval Tuesday all but ensures that Missouri will have a federally run exchange.”

“November 16th is the deadline for states to submit a blueprint to the federal government for Obamacare’s insurance exchanges — a key component of the new healthcare law. Already, the exchange system is proving to be an unmitigated disaster. No one should be surprised by this. Like so much of the president’s gargantuan healthcare entitlement, the exchanges are burdened by a spider’s web of confusing regulations, poor design, and a top-down, command-and-control structure.”