State HIX Options 'Ironic from Both Sides'

"Neither a 'state' exchange nor the expansion of Medicaid under the Orwellian-named P.P.A.C.A. would result in better 'patient protection' or in more 'affordable care,'" Texas Gov. Rick Perry said in July in a letter to Health and Human Services Secretary Kathleen Sebelius. "What they would do is make Texas a mere appendage of the federal government when it comes to health care."

Last week, Kansas Gov. Sam Brownback said in a media release that "my administration will not partner with the federal government to create a state-federal partnership insurance exchange because we will not benefit from it and implementing it could costs Kansas taxpayers millions of dollars."

Instead, Brownback said elected officials who support the health insurance exchanges would have to bring the issue before the state legislature in 2013. Brownback's statement put the kibosh on a HIX "blueprint" that Kansas insurance regulators were preparing to submit to HHS this week.

"We were ready to file a declaration letter and file a blueprint by this Friday," said Kansas Insurance Commissioner Sandy Praeger, a Republican who is serving her third consecutive term in the elected post.