The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
The last of 19 states got federal approval to start their new healthcare exchanges, created under the Affordable Care Act, the Obama administration said.
California, Hawaii, Idaho, Nevada, New Mexico, Vermont and Utah all got approval from the Health and Human Services Department to operate their healthcare exchanges, a cornerstone of President Barack Obama's healthcare overhaul, The Los Angeles Times said Thursday.
The exchanges set minimum standards for healthcare and allow those who don't have insurance through their employer to comparison shop for the plan they like best -- much like how travel websites allow comparison shopping for airline tickets.
The Obamacare law does not mandate a state create a health insurance exchange, but does hold that if an individual state does not create their own exchange or partner with the federal government to create one, the federal government will create one for them.
Most Democratic states have moved to create their own exchange while most Republican-controlled states have resisted. Only four states with Republican-controlled legislatures have created the health exchange -- Idaho, Nevada, Utah and New Mexico -- the Times said.