In this Sunday’s gospel, Jesus promises to raise “on the last day” all who come to him. The U.S. government is bracing for an unexpected, last-minute task of raising and operating new health insurance markets, known as exchanges, in about half of states by this time next year. It will be a herculean task that federal officials never expected to perform, but local officials in many states appear unwilling or unable to fulfill a key piece of the Affordable Healthcare Act.

When the U.S. Congress passed the legislation to expand coverage two years ago, lawmakers assumed that every state would set up its own exchange, a place where people could shop for insurance, compare prices and benefits of health plans offered by insurance companies, and get subsidies to help defray the cost. People will be able to file applications online, in person, by mail, or by telephone. But with Republicans in many states resisting the creation of exchanges or deterred by the complexity of the task, federal officials are preparing to do the job, with or without assistance from state officials.

“We realize that not all states will be ready to establish these exchanges by 2014, so we are setting up a federally facilitated exchange in those states,” said Michael Hash, the top federal insurance regulator. “We are on track to go live in October 2013, which is the beginning of the first open season for the individual and small group markets.”

Source: An article by Robert Pear for the New York Times