Here's a map from the Kaiser Foundation of what states have decided so far.
Other than the irony of so many "red states" choosing to let the federal government have control over their health care exchanges, its important to realize that these decisions will have a direct impact on the members of Congress representing these states.
To understand, its first important to explain how members of Congress and their staff are currently covered.
As things currently stand, Members of Congress and their staff, until 2014, will continue to participate in the Federal Employees Health Benefits Program (FEHBP). This program, considered among the best in the nation, allows federal employees- including Members of Congress and their staff- to choose from a wide range of health plans and select the one that best suits their needs.But all that changes on January 1, 2014.
...come 2014, when the lion’s share of the ACA provisions come on line, Members of Congress and their staff will be required to buy their health insurance on an exchange. In fact, their choices will be even more limited than our own. While it is expected that some 24 million people will elect to purchase their health care policy on a state run exchange, we are not required by law to do so. Members of Congress and their staff, however, must buy their insurance in this way.As so many other things that went unnoticed during the fight over health reform, this is a rather genius provision. Every member of Congress and everyone on their staff will have a vested interest in the success of these exchanges...because it is how they and their families will be covered. In a very short time, all of this is going to get very personal for them.