(Bloomberg) -- Mississippi, where one in five people lack health insurance, two Republican elected officials are fighting over the best way to resist health care reform.

Insurance Commissioner Mike Chaney is proceeding with a key requirement — creating health care exchanges to help people without employer-provided coverage get policies — saying he wants the least burdensome requirements. However, Gov. Phil Bryant asked him to stop late last month, saying the state shouldn’t advance any part of the Obama-backed law. 

In Mississippi and other states where leaders oppose the 2010 law, officials are debating whether to go along with its provisions. States that resist may test the federal government’s plans to step in and provide the insurance marketplaces.

With six weeks left to submit plans to the federal government, only 13 states — 11 led by Democratic governors, including California, Colorado and New York — have established exchanges, according to a tally by the Henry J. Kaiser Family Foundation. Sixteen other states, 14 of them led by Republicans — including Texas, Florida and Louisiana — have said they won’t create exchanges or haven’t started, according to Kaiser.

Mississippi will be better off with its own exchange, and a federal version would probably be more expensive and onerous, requiring more coverage than the state would otherwise mandate, Chaney says, adding that he can proceed without the governor’s support.

Erin Shields Britt, a spokeswoman for the U.S. Health and Human Services Department, declined to comment on who has authority to act on the state’s behalf.

Chaney says he doesn’t like the health care law, and will vote for Republican presidential candidate Mitt Romney, who has said he wants to repeal it.

But if Obama is re-elected, “I will file a blueprint for the exchange on Nov. 16, unless I get a court order from some idiot out there trying to stop me,” Chaney says.

Chaney said he has no patience with those who think non-compliance will make the law disappear.

“Southern states should know that better than anybody,” he says, referring to the region’s defiance of civil rights laws in the 1960s. “The law is the law whether you like it or not. It doesn’t matter if you like it. It’s the damn law.”

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