As federal officials consider whether to let the Nov. 16 deadline slip, governors in places such as Kansas, Virginia and Colorado are deciding whether to have the federal government design their exchange.

CQ HealthBeat: HHS Expected To Give States More Time On Exchange Decisions
The federal government is likely to extend the Nov. 16 deadline for states to decide whether they will run their own health insurance exchanges, according to several state officials. ... Instead, HHS officials are expected to set a new deadline for states that want to operate the marketplaces alone but have a rolling deadline with ongoing discussions for states that are interested in a partnership (Adams, 11/8).

The Denver Post: National, Colorado Elections Push Five Key Health Reforms Down Road
Coloradans backing major expansions of insurance and other pivotal health reforms briefly rejoiced in this week's election results, then immediately resumed a 14-month sprint to key deadlines. ... Can the state health-insurance exchange, the focal point for many of the reform movement's ambitious goals, be up and running with a friendly interface to consumers within a year? ... Will Gov. John Hickenlooper's administration enthusiastically join the national Medicaid expansion, adding hundreds of thousands to Colorado insurance rolls? Or will it take the back exit opened by the Supreme Court? (Booth, 11/9).

The Associated Press: Gov. Jindal Asked To Rethink Medicaid Expansion
Republican Gov. Bobby Jindal is being urged by Louisiana Democratic leaders and advocacy groups to reconsider his opposition to expanding the state's Medicaid coverage, now that the presidential campaign is over. ... The head of the Louisiana Democratic Party, state Sen. Karen Carter Peterson, said families, businesses and health care providers can benefit from the law's provisions. ... Jindal hadn't responded Thursday to multiple requests for comment about whether he'd change his stance (Deslatte, 11/8).

The Associated Press: Mo. Won’t Run Health Insurance Exchange By 2014
Gov. Jay Nixon acknowledged Thursday that Missouri will not be able to set up an online marketplace for residents to shop for health insurance as envisioned under President Barack Obama's health care. That means federal officials will take over the task — at least for the near future (Lieb, 11/8)

The Richmond Times-Dispatch: Va. To Use Federal Health Exchange Option - For Now
Gov. Bob McDonnell acknowledges that with the re-election of President Barack Obama, federal health care reform no longer can be stopped in Virginia, but he remains unwilling to expand the state's Medicaid program or establish a state-based health insurance exchange without more certainty about the costs. ... "I don't want to buy a pig in a poke for the taxpayers of Virginia," he said at a postelection news briefing on Wednesday. "At this point, without further information, the only logical decision for us is to use the federal option" (Martz, 11/7).

Kansas City Star: No State-Run Health Insurance Exchanges In Missouri Or Kansas
Missouri will be unable to implement a key provision of federal health care law, Gov. Jay Nixon announced Thursday. Meantime, Kansas Gov. Sam Brownback says he won't support an application from Insurance Commissioner Sandy Praeger to establish a state-federal health insurance marketplace. That means it will be up to the federal government to establish health insurance exchanges in Missouri and Kansas. ... When states do not open their own, the federal government will step in and set up an exchange (Hancock, 11/9).

St. Louis Beacon: Feds Will Set Up Missouri’s Health-Care Exchange, Nixon Says 
Fresh off his decisive re-election victory, Nixon told reporters Thursday at his office in Jefferson City that Missouri had run out of options to implement a health-care exchange, one of the provisions of the federal Affordable Care Act (Rosenbaum, 11/8). 

Kansas Health Institute News: Brownback Says No Again To Health Insurance Exchange
Gov. Sam Brownback today squelched Insurance Commissioner Sandy Praeger’s efforts to partner with the federal government on a health insurance exchange. ... “Kansans feel Obamacare is an overreach by Washington and have rejected the state’s participation in this federal program," Brownback said in a prepared statement. ... Praeger earlier this week said the grant application to help develop a state-federal partnership on a Kansas exchange did not need explicit approval by the governor but could not go forward without his tacit support for it (11/8).

Kansas Health Institute News: Groups Call For KanCare Delay
With KanCare's scheduled launch only short weeks away, spokesmen for groups representing the elderly and developmentally disabled today urged legislators to delay Gov. Sam Brownback's Medicaid makeover plan for at least six months. "We believe such an aggressive timeline, with little oversight, for an untested system will place many of the state's frailest and most vulnerable residents into a long-term managed care program that we believe the state is not ready to operate," said David Wilson, testifying on behalf of AARP Kansas to the Joint Committee on Home and Community Based Services Oversight (Shields, 11/8). 

Health News Florida: Re-Engineer Health System, CEOs Urge
The U.S. health-care system has begun a huge transformation from a cottage industry noted for waste and inefficiency to one that rewards value, four Florida health executives said Thursday. The CEOs -- two from hospitals, two from physician networks --appeared on a panel before dozens of insurance specialists at the Tampa Bay Association of Health Underwriters. Far from objecting to the Affordable Care Act, the panelists said it doesn’t go far enough in restraining costs, given demographics of an aging population (Gentry, 11/8).