By Jan. 1, 2014, the Affordable Care Act requires that every state establish a fully functional health insurance exchange, but in North Carolina, a state-based exchange isn’t going to happen by that deadline.

When the General Assembly was last in session, it did not authorize a state-based exchange, nor did the governor create an executive order (the two ways in which such an exchange could be established). The legislature won’t be back in session until January 2013, which marks the deadline for when states are required to inform the federal government if they will be ready to operate an exchange by the next year.

For North Carolina, the answer is clearly no.

“I think that it’s generally accepted by everybody in the state that time passed quite a while ago. It’s not feasible right now at ...