HHS approves 6 state-run healthcare exchanges

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The states approved Monday were the first six to apply, officials said.

"This is not a reflection on whether any other state will be approved," said Gary Cohen, the director of HHS's Center for Consumer Information and Insurance Oversight, which is handling the bulk of the implementation effort for President Obama's signature healthcare law.

HHS announced the approvals as it released a lengthy questions-and-answers document for governors, who have raised myriad questions about their roles and the scope of HHS's involvement.

The healthcare law envisions each state setting up its own exchange, while authorizing HHS to run a fallback in any state that doesn't act on its own. 

States have until Friday to decide whether they'd prefer to run their own exchange. It's entirely possible that the 14 states that have already announced their plans will be the only ones taking up exchanges themselves.

Tennessee became the latest state to reject a state-based exchange Monday.