It's safe to assume Gov. C.L. "Butch" Otter would have loved the courts or the American public to solve his little health care dilemma. For poor old Butch, though, it wasn't meant to be.

The Idaho Republican, and staunch states' rights advocate, for months has put off making a decision on what kind of insurance exchange the state should adopt as required by President Barack Obama's health insurance overhaul, counting on the Supreme Court to overturn the reforms or voters to send Obama packing and elect GOP presidential candidate Mitt Romney on Nov. 6.

Well, as we know the Supreme Court didn't strike down "ObamaCare" and Obama was soundly re-elected. Now Otter has until Friday to set Idaho's course, with options - and opportunities for stalling - dwindling.

His options include issuing an executive order to follow the governor-appointed panel's Oct. 26 recommendation to adopt a state-based, nonprofit exchange run by an independent board, proposing a joint venture with the federal government or opting for a version run from Washington.

Insurers and business groups in Idaho have made it clear they support a state exchange, with top providers proclaiming fear a federal exchange would invite a heavier hand from Washington into currently state-regulated insurance markets. They also say a federal exchange would be more expensive for Idahoans as opposed to a state exchange that could be tailored specifically to the needs of the state.

Whichever direction Otter turns, he still has the huge task of convincing the GOP super-majority in Boise to go along with the proposal when lawmakers return to the capitol Jan. 7 for the 2013 session. Many of these legislators are the same people who characterized the 2010 overhaul as a shift toward socialized medicine. That being said, we have little hope for a civil, factual or productive discussion, meaning we will likely be left with a federal exchange.

Maybe a state plan would be better for Idaho, but even a federal plan will be an improvement on status quo, and thousands of Idahoans - and millions of Americans - will soon have access to affordable health care.