Idaho Gov. Butch Otter's working group on Friday voted in favor of creating a nonprofit, state-based health insurance exchange under President Barack Obama's health-care reform law.

The working group was named by Otter and chaired by Idaho Department of Insurance director Bill Deal. It voted 10-2 in Boise in favor of an exchange built and managed by Idahoans.

A growing number of states are preparing to develop such exchanges.

Otter now has until Nov. 16 to relay Idaho's intent to the federal government. The default option was to allow an exchange to be imposed by the federal government.

"We found the path of least evil," said state Sen. John Goedde, following the Friday working group meeting. Goedde is a member of the group.

Heidi Low, executive director of the Idaho Health Exchange Alliance, in Boise, said, "A state-based exchange will help Idaho maintain local control over health insurance costs and will benefit Idaho's economic stability."

The alliance was formed to advocate a state-based exchange. The alliance has a growing membership of 316 statewide, including health-care providers, insurance brokers, several industry trade groups, and large and small businesses.

A health insurance exchange is an online marketplace where consumers can compare and purchase health insurance in one place. As many as 15 states so far have chosen to build state-based exchanges.

Goedde said a board leading the new nonprofit exchange in Idaho will be made up of stakeholders, with prominent representation by individuals and business owners, not insurance companies.

The board will have to determine how to pay for the insurance exchange, he said.

"The whole thing hinges on what happens on the sixth," he said, referring to next month's general election.

If Republican presidential candidate Mitt Romney is elected, Goedde said, Otter might not want to adopt the recommendation.

Regardless, the Patient Protection and Affordable Care Act, commonly called "Obamacare," is going to be the law of the land. The U.S. Supreme Court upheld the law as constitutional.

Goedde said cost estimates to build an insurance exchange in Idaho have ranged from $15 million to $77 million.

Goedde said an Idaho-based exchange provides the state with the most flexibility, so it operates in the best interests of Idaho citizens and employers.

Wayne Hoffman, one of the two working-group members who voted against the state-based exchange, said, "I continue to believe we must resist the federal government's efforts to take over the health-care industry."

Hoffman, of the Idaho Freedom Foundation, said Otter should tell the federal government that Idaho doesn't want to take part in the Affordable Care Act's implementation.