As the Supreme Court prepares to rule on the President’s health care reform plan, states are struggling to decide how to spend the next six months. Should they continue preparing to implement health insurance exchanges, currently required to launch in January 2014, or put plans on hold until the Court’s ruling? Two Midwestern governors have already declared that they won’t take further action until a decision is made, and the idea is gaining popularity among other states opposed to reform. But if the law does triumph in court, states will be hard-pressed to meet their deadlines: although exchanges won’t open until January 2014, HHS must decide a year prior whether states are prepared to run one.

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