That distinction belongs to Gov. Schwarzenegger's decision to sign bills establishing the first health insurance exchange in the country. Such exchanges are supposed to be web-based marketplace where individuals and businesses can purchase policies. These state exchanges are a crucial part of the major federal legislation passed earlier this year. States can either choose to set them up themselves or let the federal government do it for them. Consumers will be able to buy from such exchanges beginning in 2014.
By choosing to go forward, California is seizing the opportunity to shape the future. But there are risks to going first. The establishment and design of the exchange here deserves rigorous scrutiny, particularly on difficult questions related to cost. If California can figure out a way to make health insurance better and cheaper, it will have done itself, and the country, a service.