About half the states in the U.S. have not formalized plans for insurance exchange marketplaces as part of the health reform law. Some state governments are waiting for the Supreme Court to issue a ruling on the law’s constitutionality. Other officials are banking on a sweep in the November election that will empower Republicans to repeal or revise the law. The law requires states prove it has made sufficient progress toward setting an exchange up by Jan. 1, 2013, or face a federal takeover. Lawmakers and analysts on both sides of the debate say the foot-dragging is more a political statement than strategy to derail implementation of the health reform law. A number of Republican governors have announced that they would not want to cede responsibility for the exchange to federal authorities if the law survives.
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