North Dakota is on its way to becoming the first state in the country to have an operating health insurance exchange program. Each state is required by the Affordable Care Act to have some infrastructure in place by January 2013 for an exchange. Florida remains one of the lone states dragging its feet.

The Grand Forks Herald reports that North Dakota is on track to pass legislation that would set up its state exchange.

According to the Herald:

House Bill 1474, drafted by the Health Care Reform Review Committee after the regular legislative session ended this spring, would create a North Dakota health insurance benefit exchange system.

Under the federal legislation, all states must have an operational health benefit exchange by Jan. 1, 2014 or the secretary of Health and Human Services must create one.

Pam Sharp, director of the North Dakota Office of Management and Budget, said the key component of the exchange would be a new website that would allow residents to compare costs and benefits of affordable health insurance plans.

The Center on Budget and Policy Priorities released a report (.pdf) that said as of “August 17, 2011, 39 states and the District of Columbia have introduced some form of legislation promoting exchange implementation.”

“Among the 34 states where the legislation would fully establish a state exchange program, ten states enacted such bills into law,” the group reports.

Only 11 states, Florida among them, have not introduced any legislation to establish a state exchange program.

Florida is among only five states not using federal grants meant to help the state plan and research for an exchange. The Center on Budget and Policy Priorities says that “Florida, Kansas, Louisiana, New Hampshire and Oklahoma reportedly will return exchange grant funds.”

This week, health advocates touring the state warned that Florida had done “virtually nothing” to follow the law’s mandates. The groups also warned that the state would cede their authority to the federal government if the state did not meet the deadlines.

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