Gov. Nathan Deal has decided that Georgia will not set up its own health insurance exchange, instead leaving the matter up to the federal government.

Deal’s decision follows the path of many other Republican governors in turning down participation in Obamacare’s plan for state-run exchanges with a start date of January 2014. The exchanges are supposed to serve as markets for individuals and small businesses to shop for private insurance coverage under federal regulations.

Already 20 states have opted out of the plan — and for good reasons. In his letter to the Obama administration last Friday, Deal said: “I remain concerned with the one-size-fits-all approach and high financial burden imposed on states by this federal mandate.”

Two huge problems are the unknown costs and the unknown federal regulations — yet to be disseminated. Gov. Rick Perry of Texas made the points in his rejection letter to Health and Human Services Secretary Kathleen Sebelius. He wrote: “As long as the federal government has the ability to force unknown mandates and costs upon our citizens, while retaining the sole power in approving what an exchange looks like, the notion of a state exchange is merely an illusion.” The rules for the new system “have not even been written,” he said.

Republican Govs. Bob McDonnell of Virginia and Bobby Jindal of Louisiana laid it on the line in a letter to Obama: “States are struggling with many unanswered questions and are not able to make comprehensive far-reaching decisions prudently.” They had asked for a meeting with Obama and postponement of a Nov. 16 deadline for deciding on the state-run exchanges. The day before the deadline, the Obama administration extended it until Dec. 14 but so far is sticking to its plan to launch the health care plan’s expanded coverage Jan. 1, 2014.

Going against the grain with Republicans, Mississippi insurance commissioner Mike Chaney decided to set up an exchange. He said he doesn’t like Obamacare. “I think it needs to be repealed. But it is the law. If you default to the federal government, you forever give the keys to the state’s health insurance market to the federal government.” That may be food for thought, but on this, Deal and his fellow Republican governors are on the right track.

Deal said the exchange would be “state-based in name only.” He explained: “I would support a free market-based approach that could serve as a useful tool for Georgia’s small businesses but federal guidelines forbid that. Instead, restrictions on what the exchanges can and can’t offer render meaningless the suggestion that Georgia could tailor an exchange that best fit’s the unique needs of its population.”

Deal said he and other Republican governors are “seeking guidance from the federal government on establishing exchanges. We’ve yet to receive serious answers to our questions. I will not commit Georgia taxpayers to a project with so many unknowns.”

That much is clear, but it’s not clear what will happen to the insurance market in this state.

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