As the effective date for the next major step in creating a public health insurance program nears, Florida’s residents are once again being left in the lurch by the state’s leaders, led by Gov. Rick Scott. The state has refused to lift a finger to create state-run insurance exchanges, and Florida is increasingly isolated in this position, even among Republican-led states.

Affordable insurance exchanges are the public marketplaces that will allow each state’s residents to look for and compare private health plans, get answers to questions about coverage options, and enroll in a suitable plan.

They can also find out if they are eligible for programs or credits to make coverage more affordable. Come January 14, 2013, that kind of information will be useful, not to say vital, for nearly everyone except those with employer-provided healthcare insurance.

The governor’s contempt for the federal healthcare insurance program is well-known. He made that clear when he ran for office and once elected did everything he could to shoot it down — including enthusiastic support for the state lawsuit against “Obamacare” that the U.S. Supreme Court ruled against.

Once the court made its decision, the governor should have put aside his own political views and ordered the state to create the exchanges, even if he had to hold his nose while doing so, for the sake of Florida’s residents.

After all, that’s what a number of his own Republican colleagues across the nation are doing.

In Arizona, Gov. Jan Brewer — a tough conservative by any measure — is allowing the state to design an insurance exchange that fits her state’s needs. Next door, in New Mexico, GOP Gov. Susana Martinez also plans to submit an insurance exchange proposal.

In Nevada, another prominent Republican, Gov. Brian Sandoval, is one of those taking a practical and realistic approach. “We must also plan for a Health Insurance Exchange so that we — and not the federal government — control the program,” he told state legislators.

In all, 22 states run by Republican governors are going ahead with the exchanges, at least to the point of exploring their choices. Some of them will wait until after the election before making the final commitment, but at least they’re wisely keeping all their options open.

If states haven’t made a decision by November 16, the federal government will run it for them. It’s not clear — certainly Mr. Scott has never explained — how this makes anything about this process better either for Florida’s residents or for those who want to minimize the federal government’s role in healthcare insurance.

In Mississippi, another Republican-run state, Insurance Commissioner Mike Chaney has come under fire for taking an active role in creating the exchanges, but hasn’t been deterred.

“A healthcare exchange is not a partisan political issue,” he said. “Across this nation, Republicans and Democrats alike have embraced the concept of health exchanges as a way to help individuals and small businesses more easily obtain health insurance.”

That’s the argument in a nutshell. It may not be too late for Florida to work up its own design for an exchange. There’s federal planning money available, and Gov. Scott should waste no time taking advantage of it.

If Gov. Brewer of Arizona, who denounced the Supreme Court’s healthcare ruling, can come to terms with the decision for the sake of her state’s residents, Mr. Scott should be able to do the same.