"The real question for Republican governors is, 'Are you going to let the feds come into your state?'" Ramlet said. "The question for the Obama administration is whether they are going to have more flexibility."
Major regulations due shortly and covering issues including exchange operations, benefits and protections for people with pre-existing health problems could signal the administration's willingness to compromise.
A recent check by The Associated Press found 17 states and the District of Columbia on track to setting up their own exchanges, while nine have decided not to do so. The federal government could end up running the new markets in half or more of the states.
The states on track include California, Colorado, Connecticut, Hawaii, Kentucky, Maryland, Massachusetts, Minnesota, Mississippi, Nevada, New York, Oregon, Rhode Island, Utah, Vermont, Washington, and West Virginia.
The nine definitely not setting up exchanges are Alaska, Florida, Louisiana, Maine, New Hampshire, South Carolina, South Dakota, Texas and Wisconsin. Missouri and others are likely to join the list.
As far as Medicaid, 11 states and the District of Columbia have indicated they will expand their programs, while six have said they will not. That leaves more than 30 states undecided.
The states definitely expanding Medicaid include California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Minnesota, New York, Vermont, and Washington. Those declining include Florida, Georgia, Louisiana, Mississippi, South Carolina, and Texas.
On Capitol Hill, Republicans say if a budget deal is going to include tax increases, it must also come with cuts to the health care law, or money-saving delays in its implementation.
While major changes can't be ruled out, they don't seem very likely to former Senate Majority Leader Tom Daschle, D-S.D., who is close to the administration.
"I think Democrats are increasingly emboldened about the health care act," Daschle said. "The president won re-election partly by defending it. There is a new dynamic around the health care effort."
Republican attempts to amend the law will continue, he added, but outright repeal is no longer a possibility. "Budgetary issues will continue to be a big question mark," said Daschle.
- Survivors visit Auschwitz a day ahead of 70th...
- Victim of sexual abuse sues Boy Scouts of...
- Denver police shoot, kill teen who struck...
- California bars judges from Boy Scouts...
- Chess in schools: bringing the classic mind...
- Some Republican presidential hopefuls court...
- Miss Colombia crowned Miss Universe in Miami
- Man tells police drone crash at White House...
- California bars judges from Boy Scouts... 86
- Kerry: Violent extremism is not Islamic 29
- Measles outbreak casts spotlight on... 20
- Idaho has 22 breeding wolf pairs, an... 12
- Religious response to postponed... 12
- Some Republican presidential hopefuls... 11
- VP Joe Biden: More access to higher ed... 10
- 'Potentially historic' blizzard... 10