Last week, Idaho's health insurance exchange study group set up by Republican Gov. Butch Otter voted in favor of a state-run exchange, with only two of the panel's 13 members opposing the decision. While he has been an outspoken critic of the ACA, Gov. Otter has also indicated his preference for a state-run exchange. The decision whether to establish a state-run exchange or allow the federal government to do it must be made by Nov. 16.