The more states that decline to set up a state-run exchange, the bigger the task that will fall to the federal government, which must set up and run insurance marketplaces in their place under ObamaCare. That could prove a difficult mandate given that all exchanges are supposed to be operational by Jan. 1, 2014
State-run exchanges — within still-unclear federal mandates — could determine plan benefits, determine eligibility and handle enrollment. But many states — mostly with Republican governors — say creating and running their own exchanges offers heavy costs and responsibilities but little autonomy or clarity.
Setting up exchanges means states co-own ObamaCare, for good or ill. When problems develop, state officials will take some of the heat. But Washington will be fully responsible for federal exchanges.
