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States face decisions about setting up online health insurance marketplaces, and a mid-November deadline for declaring their intentions has sparked conflicts between governors and legislators across the country.
In two GOP strongholds, Kansas and Mississippi, elected insurance commissioners are at odds with governors, even though they're all Republicans.
In Kansas, Insurance Commissioner Sandy Praeger's disagreement with Gov. Sam Brownback has political consequences for her. She's among a dwindling number of GOP moderates.
Praeger disclosed in a recent interview that she's all but decided against running again in 2014 and acknowledged she'd have difficulty winning a Republican primary.