18 states intend to operate their own wellness exchanges In a Monday post by Health and Human Services Secretary Kathleen Sebelius This total was announced online . On the other hand, Virginia Gov. Bob McDonnell announced Monday that his condition will bow out of the another key facet of the health law: Medicaid growth. Reuters: Health Insurance Exchanges Planned By 18 U.S. States: Sebelius The deadline for says to inform the government if they would operate healthcare exchanges under President Barack Obama's health care reform legislation was December 14. The number of says participating was consistent with targets and leaves the federal government to create online marketplaces for the rest of the country.