Some 50 million Americans still lack health insurance. That will change for the greater majority when the Affordable Health Care Act, or Obamacare, as it's more commonly known, rolls out over the next couple of years.

While the bulk of the law goes into place in 2014, you'll see a few changes this year. However, much of 2013 will be dedicated to health facilities and government offices getting ready for the larger changes coming down the road.

On Thursday, the Department of Health and Human Services conditionally approved eight more states' plans to set up their own health insurance exchange programs. The conditional approvals mean a total of 19 states plus the District of Columbia have the initial thumbs-up on their plans.

Two others, Arkansas and Delaware, have the go-ahead to run an exchange in partnership with the federal government.

States can decide to set up an exchange at any time, but the clock is ticking. States that plan to partner with the federal government need to do so by February 15. People not living in a state with an exchange have access to a federal program. All the exchanges are supposed to be up and running by October 1 of this year.
In a conference call with reporters Thursday, Health and Human Services Secretary Kathleen Sebelius said she was encouraged by the progress states have made so far.

"From the beginning, this process has been guided by our belief that states know their own needs better than anyone else," Sebelius said. "That's why we have worked so hard to give states the flexibility and resources to create and participate in marketplaces that work best for their citizens, and it's encouraging to see so many states moving forward to do just that."

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