Kentucky and most other states continue to delay action on health-insurance exchanges, despite Jan. 1, 2013 deadline

Though states must be able to prove whether or not they're ready to run a state insurance exchange by Jan. 1, 2013, many, including Kentucky, have not made any moves toward setting one up.

Kentucky officials have said they are waiting for more guidance to come from the federal level before anything can be decided, but there were indications that the administration of Gov. Steve Beshear might have been delaying action until last month's gubernatorial election. If Kentucky were to set up its own exchange, a move would likely have to be made in the 2012 General Assembly.

Jason Millman of Politico Pro writes an easy-to-understand summary of the complex issue and what it will mean for the American public: "Set to open in January 2014, exchanges will offer a marketplace where individuals and small businesses in each state can shop for health coverage. The exchanges, which offer subsidized coverage to lower- and middle-income individuals, will absorb more than half of the law's projected expansion of health coverage to 32 million people."

Some Republican-dominated states are waiting to see if the U.S. Supreme Court will rule the federal health-care reform law or its individual mandate unconstitutional, but a ruling is not expected until June at the earliest. "If that's when they start to work on an exchange, they will certainly be challenged to have a state-based exchange in 2014," said Steve Larsen, who oversees exchange development for the U.S. Department of Health and Human Services.

Wisconsin state Sen. Frank Larsee, chairman of the insurance committee, plans to wait even longer — opting to wait until after the 2012 presidential election. "Exchanges really aren't required until 2014, so we have plenty of time after November 2012," he said, not addressing the Jan. 2013 deadline.

So far, just 13 states have passed legislation to form an exchange. (Read more)