For more than a year, Secretary Kathleen Sebelius and others at the U.S. Department of Health and Human Services have been courting states to take part in setting up and running a health insurance exchange. But Missouri, home of an enthusiastic governor and opposing legislature, keeps sending mixed messages. Now, with Friday’s deadline looming for states to commit to joining the feds in setting up an exchange, it appears as though HHS will be flying solo in the Show-Me state.