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• "After extensive research and analysis, it has become very apparent that operating our own exchange will simply not work for South Dakota," Daugaard said in a written statement.
• After the Supreme Court upheld the health law in June, Daugaard said the state wouldn't implement any part of the law until at least after the November election in the hope that a new president and new Congress would overturn it. The state faces a deadline of Nov. 16 to let federal officials know whether it would operate its own insurance exchange.
• On Wednesday, the governor said annual operating costs for a state-operated exchange would be too expensive, costing between $6.3 million and $7.7 million.
• "The federal law requires exchanges to be self-sustaining by 2015, which means we would either have to charge a fee to South Dakota citizens using the exchange, or increase taxes, neither of which I am willing to do," Daugaard said.
• Kirk Zimmer, chief executive officer of DAKOTACARE, an insurance company operated by the South Dakota Medical Association, said the availability of insurance will not be affected by whether the exchange is run by the state or federal government.
• "I don't think it will affect an insurance company's decision to participate in the exchange or not," Zimmer said.
• Deb Fischer-Clemens, director of public policy for Avera Health, which runs hospitals, clinics and its own insurance plan, said she supports the governor's decision because a state-run exchange would cost too much. The state apparently will keep its authority to regulate insurance after a federal exchange is created, she said.
• "I think it's the only option the governor has at this time," Fischer-Clemens said.
• House Democratic Leader Bernie Hunhoff of Yankton said he believes state lawmakers should have been allowed to decide whether the state sets up its own exchange.
• "I think that should be a decision made not just by the governor but by the Legislature, with the public at large weighing in," Hunhoff said.
• Hunhoff said he doesn't know if a state-run exchange would be better than one operated by the federal government, mostly because no one knows that the federal exchange will include. But a federal exchange may not take into account issues important in South Dakota and other rural states, he said.
• "I'd be worried that the Washington answer might not be the right answer for South Dakota," Hunhoff said.
• Dave Hewett, president of the South Dakota Association of Health Care Organizations, said he believes the governor is justified in letting the federal government

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