Idaho's state insurance director, Bill Deal, said he was surprised that this morning's health care ruling from the U.S. Supreme Court upheld the individual mandate. "So now we know, and we can move forward, with hopefully some good direction in mind," he said.

As for a health insurance exchange in Idaho - which lawmakers refused to begin planning for during this year's legislative session, betting that the law would be overturned - Deal said, "It leaves us basically at square one." Idaho had a $20 million grant to begin planning its exchange, but lawmakers rejected it. "That money's essentially off the table," Deal said. "So there are other grants that are available, but we're going to have to really sit down and determine if we go for grants, if the Department of Insurance and Health & Welfare will get spending authority to move forward with what now would be implementation." It's also unclear whether the federal government will now impose a federally run exchange on Idaho. "At this point I can't tell you," Deal said. He said his office is still working to "decipher" and "digest" the decision, and likely won't know how it will proceed for several weeks.