The Centers for Medicare and Medicaid Services a week ago conditionally approved the first six states to build health information exchanges; now it has also has approved Kentucky, New York and the District of Columbia.

With the earlier approval for HIX in Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington, about half the states or territories that will build their own changes have been OK’d.

More than 30 states, primarily led by Republican governors, are likely to not build their own exchanges but to partner with the federal government or leave the entire task to the feds.

States had until Dec. 14 to decide their HIX strategy; those not building their own have until Feb. 15, 2013, to decide if they want a partnership or let the federal government run the exchange. A partnership gives states some say in the standards that insurers must meet to sell benefit plans through the exchange.

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