WASHINGTON - U.S. Department of Health and Human Services officials are hinting that a final ruling detailing the structure for state health insurance exchanges is imminent, Congressional Quarterly reports. For those states that fail to establish a state exchange or are unable to get them up and running by January 2014, federal officials are working to establish a fallback federal exchange, according to Steve Larsen of the Centers for Medicare and Medicaid Services.

"We often hear when we??re out talking, in some states, that people think there won??t be a federal exchange or we??re behind. I can tell you that there is a ton of work going on and we??ll be ready," Larsen said.

The exchange regulation is the last phase of implementation of the health care law and will serve as a marketplace for the sale of health insurance to individuals and small groups.

The Office of Management and Budget is reviewing the rule, whose details were proposed eight months ago.

Larsen said despite objections to the Affordable Care Act by some Republican governors, states are still moving forward with preparations.

"There are a lot of Republican-governor states that are really making progress, and plaintiff states," Larsen said, referring to states that are among the 26 challenging the law in court.

"Although there are some that continue to oppose the Affordable Care Act, they understand if this is the law of the land, and we think it is going to be after the Supreme Court rules, they will be pretty far behind if they don??t start to take action now," he said.