“Having failed to persuade 26 states that participating in ObamaCare is a good deal, the liberals behind the law are denouncing these dissident Governors as federalist hypocrites. A few critics on the right are chiming in and arguing that the 26 are inviting worse results once the feds swoop in. So someone ought to say a word on behalf of the people who run state governments in the real world and have examined the health insurance ‘exchange’ question in detail. They’ve seen enough to know that the choice to set up and run these insurance bureaucracies is not a choice at all.”

“The federal government will likely be involved in running the ObamaCare exchange in at least 30 states, 26 of which expressly declined to establish state exchanges. One health-policy expert refers to it as an ‘administrative nightmare’ for the Department of Health and Human Services. Friday was the deadline for a state to let HHS know if it planned to establish a state exchange. Thus far only 18 states and the District of Columbia are planning on doing so.”

“Pennsylvania will not set up its own health care exchange under the federal Affordable Care Act, at least not for now, Gov. Tom Corbett said Wednesday, putting the state on a course to join others led by Republicans that will let President Barack Obama’s administration run its exchange. Setting up a state-based exchange would be irresponsible, Corbett said, as he faulted federal authorities for what he called inadequate answers to his questions about cost and other issues.”

“Recent decisions by the Obama Administration concerning the health care exchanges and Medicaid expansion underscore what a risky proposition the Patient Protection and Affordable Care Act (PPACA) is for the states. Congress presumed in PPACA (Obamacare) that the states would agree to build and run exchanges and could be forced to expand Medicaid. The Supreme Court, however, ruled the Medicaid expansion voluntary, which has made states increasingly concerned over new burdens related to costs, control, and coverage—in both the exchanges and Medicaid.”

“New Jersey Gov. Chris Christie (R) declined to set up a state-based insurance exchange under the healthcare law Thursday — the same day he met with President Obama on Hurricane Sandy aid. The move will be welcomed by conservatives who blamed Christie for praising Obama’s response to the storm. Sandy hit just before the election and distracted national media coverage from Obama’s campaign against Mitt Romney. “

“States already struggling to get by will face even tighter fiscal constraints thanks to yet another costly Obamacare mandate. A study last week from the Kaiser Commission on Medicaid and the Uninsured revealed President Obama’s health care takeover would dump $1 trillion in new costs on federal and state taxpayers over the next decade.”

“But the real story is that Democrats are reaping the GOP buy-in they earned. Liberals wanted government to re-engineer the entire health-care system and rammed the Affordable Care Act through on a party-line vote, not stopping to wonder whether it would work. Now that implementation is proving to be harder than advertised, they’re blaming the states for not making their jobs easier.”

“Arizona Governor Jan Brewer said on Wednesday she was rejecting a major provision of President Barack Obama’s healthcare reform law that calls for creating state-based health insurance markets where consumers can purchase private, federally subsidized coverage.”

“There’s a pretty stark choice for states to make on health-insurance exchanges right now: They can decide to set one up. Or they can decide not to. Those, along with one choice where the state and feds divvy up the responsibilities, are the options on the table. That seems to be true everywhere — except Utah. There, Gov. Gary Herbert is trying to carve out a completely new option: Building a health insurance exchange that is near certainly out of compliance with the federal law, and seeing how the Obama administration responds.”

“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.”