Governor suggests he could use other mechanisms to establish a health insurance exchange in accordance with 2010 law ALBANY — Establishing a health insurance exchange for the Empire State has cropped up as a flash point in the debate over this year's state budget, officials said, but Gov. Andrew Cuomo suggested this weekend that he is willing to drop it from this year's spending plan. The exchange is required under the 2010 federal health care overhaul — sometimes referred to as "Obamacare" — to allow uninsured individuals or small businesses a place to shop for coverage. If the state doesn't act, federal authorities will establish an exchange. "I'm working very hard to make it part of the budget," Cuomo told reporters after a speech Saturday. "The Senate is resistant to putting it in the budget. I said there are a number of options to accomplish setting up a health exchange." One of those is the use of an executive order, Cuomo said, though he acknowledged it would be subordinate to legislative action. The exchange is currently envisioned as being run by a separate public authority, which would take federal money to perform several needed studies and then begin full operation by 2014. An executive order could only apply to state agencies, which might be less nimble in their execution — and less preferable to insurers. Hence the push. "It appears the major stumbling block to a budget agreement," said Blair Horner, a vice president for advocacy at the American Cancer Society's New York chapter. "It's the only issue I know of where the Senate leadership and the governor are at loggerheads, and in Albany, nothing gets done until everything gets done." Assembly Majority Leader Ron Canestrari, D-Cohoes, noted his chamber passed legislation setting up an exchange in June 2011. He said there was an agreed-upon bill that Senate Republicans walked away from after some members of their 32-member conference complained about supporting a plan that the national GOP has opposed as a central plank. They have an issue with 'Obamacare,' or something, but there's a lot of money at stake," said Canestrari. Still, he and other legislative sources indicated there was no stalemate, but slow, grinding progress. Key staffers worked through the weekend, and many remained at the Capitol Sunday evening. "We don't believe there are any obstacles to a fiscally responsible budget that is on-time, if not early," said Scott Reif, a spokesman for Senate Republicans who were resisting the exchange. There was still no announced agreement over changes to a $250 million pot of education funding that Cuomo had hoped to dole out as competitive grants; legislators, amid lobbying from school districts and teachers unions, reduced it. There also was no resolved version of language Cuomo proposed that would give him flexibility to move money between agencies after the budget was adopted, for "efficiencies," he explained. Legislators felt the request infringed on their constitutional obligations. The plan through the weekend had been to print at least some budget bills before midnight Sunday, which would allow them to age the required three days before possible action Wednesday. A budget must be passed by March 31. Without final agreements Monday, Cuomo would be forced to issue "messages of necessity," which can waive the required waiting period, to gain the political win of an on-time budget. Such messages were used earlier this month to pass a pensions restructuring bill, and have been criticized by good-government advocates. "There's still optimism and feeling that it's happening, but it's still not all nailed down in print yet," Canestrari said.