Friday was the deadline for states to notify the federal government of their plans, and administration officials had been hoping that Mr. Obama’s re-election would overcome resistance to the new health care law.
But in Virginia, after more than a year of planning and research, Gov. Bob McDonnell said his state would not operate its own exchange. “Despite repeated requests for information, we have not had any clear direction or answers from Washington until recent days,” Mr. McDonnell said.
On Monday, Ms. Sebelius gave preliminary approval to state-based exchanges being established by Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.
The exchanges are online supermarkets where people can shop for private health insurance and obtain federal subsidies to help defray the cost. The Congressional Budget Office has estimated that 25 million people will eventually receive coverage through the exchanges.
Federal officials and federal contractors will set up and run the exchange in any state that is unable or unwilling to do so.
Pennsylvania seriously considered running its own exchange, but Gov. Tom Corbett said on Wednesday that he would not pursue the idea.
“State authority to run a health insurance exchange is illusory,” Mr. Corbett said. “In reality, Pennsylvania would end up shouldering all of the costs by 2015, but have no authority to govern the program.”
In Tennessee, state officials did a huge amount of planning for a state-run exchange. But Gov. Bill Haslam announced this week that he had decided against the idea because the Obama administration had failed to answer numerous operational questions.
Gov. Chris Christie of New Jersey cited similar concerns in vetoing legislation to establish a state-based exchange last week. (Full story)