U.S. says 28 states took steps on health insurance exchanges

WASHINGTON (Reuters) - The Obama administration said on Wednesday that 28 states have taken steps to establish insurance exchanges under the 2010 healthcare law, despite the legal and political uncertainties threatening the overhaul.

Fourteen states, including several led by Republican governors, have enacted legislation or already have the authority in place to set up the regulated insurance markets that are a key segment of the Patient Protection and Affordable Care Act, according to a report by the Department of Health and Human Services.

An equal number of states have acted through executive orders or authorized studies aimed at demonstrating the value of exchanges, which are intended to extend coverage to 16 million uninsured Americans across all 50 states and the District of Columbia, the report said.

President Barack Obama's signature domestic policy move faces a Supreme Court ruling before July that could strike down its main provisions and a November presidential election that could lead to its repeal in 2013 if a Republican captures the White House.

Uncertainty about the law's future has encouraged some states to hold off on the complex task of creating an insurance exchange, despite a January 1, 2013, deadline for states to act on an exchange or cede control of the program to the federal government.

But in their latest move to demonstrate progress in health reform, administration officials said they could provide assistance to states that miss the 2013 deadline to ensure their participation.

"We're going to meet states where they are, and ... we're going to work with them to get them as far down the path as we can," said an administration official who spoke on condition of anonymity at a briefing with reporters.

The official said the administration has the full capacity needed to ensure that qualified Americans in all 50 states would have access to an insurance exchange, whether state governments act or not.

"If for some reason, a state is not ready for operation on January 2014, there will be an exchange in place for the citizens of that state," the official said.

(Reporting by David Morgan; Editing by Cynthia Osterman)