This article is interesting because it discusses some of the differences across states. Under the PPACA, states have three options: They can run their own state-run healthcare exchange, they can enter a shared-responsibility partnership with the Federal Government, or they can allow the Federal Government to take full responsibility. At this time, 17 states (plus Washington D.C.) have decided to set up state-run exchanges. There are 20 states that are asking for the Federal Government to take full responsibility; plus 5 that are forming a shared partnership. The remaining states, including Pennsylvania, are waiting for questions to be answered by the U.S. Department of Health and Human Services (HHS). According to HHS Secretary Kathleen Sebelius, states are required to declare their intent to run their own exchange by Dec. 14, 2012 or they will forfeit that responsibility to the Federal Government.
One of the challenging items for Governors and state governments in their decision process is that the regulations governing the operation of the exchanges are incomplete. Joel Ario, the former director of the Office of Insurance Exchanges at the HSS is concerned that the Federal Government may not be able to meet the PPACA deadlines for setting up the exchanges.
Link to article: http://www.lifehealthpro.com/2012/11/16/who-will-start-a-ppaca-exchange