Lack of state exchange laws squeezes planning effort, officials say

Jones discussed exchanges Wednesday at a forum sponsored by the Bipartisan Policy Center.

Although Virginia is among the states challenging the healthcare law in court, Jones said she hopes the state legislature will vote to establish an exchange during its 2012 session.

Linda Sheppard, who leads part of the implementation effort in Kansas, said she's also hoping for a state exchange bill in 2012. If the legislature doesn't establish an exchange, she said, the state might look toward the federal government's offer to divide responsibilities between states and the Health and Human Services Department.

State officials at Wednesday's event also seemed cool to the idea of regional exchanges. The healthcare law authorizes multi-state agreements, which could either combine several states' populations or serve a narrower group of people in multiple states.

Sheppard said analysts had considered a regional exchange with Missouri that would serve the Kansas City metro area, but decided to focus first on the statewide exchange. Officials from Maryland and Washington also said they're not interested — at least for now — in combining their efforts with neighboring states.