The deadline for state officials to decide whether they want to operate their own health insurance exchange or if they want the federal government to do it has been extended for a month.

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Today was originally the deadline for those decisions to be made.

Gov. Bill Haslam said earlier this week that he would continue to weigh the options until the deadline, but that was before it was extended, so it remains unclear what Tennessee will decide and when that decision will be made.

All of this uncertainty has meant thatBlueCross BlueShield of Tennessee leaders have prepared for either option.

“It’s the state’s decision,”Chris Ramsey, director of the Office of Health Care Reform at BCBST, said. “We intend to participate in the exchange, whether it’s state or federal. Our preference is a state-based exchange.”

Under President Obama’s Affordable Care Act-which will provide health care coverage to 30 million people-exchanges must be implemented. They will allow individuals and small business owners to shop for insurance coverage via Internet-based exchanges, according toThe Tennessean.

Earlier this week, Gov. Bill Haslam said he is having to choose the lesser of two evils and that it might be easiest to defer to the federal government’s exchange, but he isn’t sure that is what is best for state residents,according toThe Tennessean.

It could cost the state between $20 and 40 million to run its own program, based on estimates from other states, also according to archives.

Haslam, who is against the health care reform, is waiting on federal officials to answer questions about how state exchanges can be run, The Tennessean also reported.

State leaders are expected to let federal officials know which way they are leaning today, but for BCBST leaders, a state exchange would be easier, Ramsey said.

“We have existing relationships with the folks in Nashville,” he said. “That’s really the main reason.”

The biggest challenges for BCBST leaders involve time constraints, he also said.

Enrollment for the exchanges will start Oct. 1, 2013, and coverage will be effective Jan. 1, 2014, Ramsey said.

Between now and those dates, insurance companies have details to get in order, Ramsey said.

For example, providers must become certified as qualified health plansin order to offer products, solocal leaders are working to meet those requirements, Ramsey said.

Products will also have to be reviewed either by state or federal leaders, depending on which type of exchange Tennessee goes with.

“There is a lot of work that needs to be done … [such as taking steps toward] becoming certified to be a quality health plan, in product development and getting [product] approval,” Ramsey said.

Updated @ 9:18 a.m.on 11/16/12 to reflect the fact that today’s deadline has been extended for one month by the Obama administration.