Department of Health and Human Services Secretary Kathleen Sebelius yesterday announced a delay until Dec. 14 in the deadline for states to declare whether they will build their own health insurance exchanges. Late last week, HHS extended to Dec. 14 the deadline for states to submit a blueprint for their state-based health insurance exchange but said states still had to make their intent known by Friday, Nov. 16. In addition, HHS extended to Feb. 15, 2013, the deadline for states to submit plans to the agency if they elect to participate in a partnership exchange with the federal government. The Patient Protection and Affordable Care Act requires states to establish exchanges to facilitate the purchase of qualified health plans in the individual and small group markets beginning in 2014. For states that do not create an exchange, HHS will create and operate a federally facilitated exchange.