Republican governors in at least four states--Florida, Louisiana, South Carolina and Wisconsin--have announced that their states will not build health insurance exchanges under the Affordable Care Act.

Under the law, the federal government will establish a health insurance exchange in states that decline to have one operational by 2014.

Some of the state decisions have asterisks: Florida will comply with HIX provisions if the reform law or the HIX provision are not repealed before Jan. 1, 2014. Wisconsin Gov. Scott Walker halted work on an exchange in 2011 pending the Supreme Court ruling, and now says he’ll decide on whether to build an exchange following the November elections.

Led by Sen. James DeMint (R-SC) and Rep. Michele Bachmann (R-MN), 73 members of the U.S. Senate and House on June 29 sent a letter to the National Governor’s Association urging governors to oppose creation of state insurance exchanges. “These expensive, complex and intrusive exchanges impose a threat to the financial stability of our already fragile state economies with no certainty of a limit to total enrollment numbers,” the letter asserts.

Text of the congressional letter is here.

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