The Obama Administration on Monday released new guidelines for state-run health insurance exchanges to help reach the main goal of the 2010 federal healthcare reform law that every American will have health insurance.

The new 643-page regulation, released by the Department of Health and Human Services, aim to provide state lawmakers and officials considerable autonomy and flexibility to meet the January 1, 2014 deadlines of developing state and regional insurance markets.

The new federal guidelines are meant to provide states recommendations on how they should establish exchanges, pass health plans and determine which individuals and small businesses are eligible to use exchanges to provide health coverage to their employees.

Health insurance exchanges are intended to provide individuals and small businesses the ability to compare insurance plans that are available in their states and to find out whether they qualify for tax credits or for government benefits like Medicaid, and the Congressional Budget Office predicts that 24 million Americans will buy health insurance though public state exchanges by 2019.

The state exchanges , which will work as federally subsidized state-run Web-based market for consumers to review affordable health plans that meet minimum quality standards and to apply for financial aid, is half of a two-pronged effort to give health coverage to about 30 million uninsured Americans under the Patient Protection and Affordable Care Act. The other part also calls for a substantial expansion of the joint federal-state Medicaid program for the poor.

However, many states are hesitant to start the process of implementing the health reform, and the ultimate performance of state exchanges could soon be determined by a landmark Supreme Court case of 26 states and a business group claiming that the new healthcare reform is unconstitutional because it requires most adults to either buy private health insurance or face a penalty.

Supreme Court hearings will begin in just two weeks on March 26 and last till March 28, and a final ruling is expected by July 1.

While many states are delaying the developmental process of construction exchanges until the ruling is out, about 33 states have already received government grant money to help set them up.

The new regulation marks a January 1, 2013, deadline for state exchanges to meet federal requirements, but would allow states to qualify after January 1 if they prove that their exchanges will be complete and ready to offer open enrollment by October 1, 2013.

If a state fails to meet federal standards by the deadline, the government will step in and establish its own exchanges.

The government is still developing a national regulation to establish the most important health benefits that insurance plans must provide in order to qualify for participation in the exchanges.

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