Many state legislators are wary of setting up state-based health insurance exchanges, as they should be. However, a new option has become available and being talked about with greater frequency: The Health Care Compact.
Health care compacts are interstate compacts, or agreements between states, that allow states to take federal money and create health care regulation for only the states included in the compact. Basically, it is a method that could possibly allow for more autonomy within and between states using federal funding. More specifics on compacts can be found here.
Many argue that compacts, as opposed to the required health insurance exchanges regulated by the federal government, give more control back to individual and groups of states. The greater independence comes mostly from the increased self-governance of member states with federal funds being guaranteed, required to be spent on health care and not subject to annual appropriations.