The Obama administration continues to scramble in an effort to convince states to create their own so-called insurance exchanges, which were established under the health care overhaul.
But so far, 25 states have rejected the idea -- forcing the federal government to do it instead.
"They've essentially said to the federal government, 'we don't ... really want to be a part of trying to clean up this train wreck we see coming'," said Jim Capretta of the Ethics and Public Policy Center.
Health and Human Services Secretary Kathleen Sebelius initially moved the exchange deadline for states from November to December, and then from December to January -- and finally just left it open altogether:
Former Congressional Budget Office director Doug Holtz-Eakin said "the most recent announcement basically said 'look, do what you want, get it done when you want, please do something'."
Many say the federal government is also far behind in setting up the exchanges, due to be in place by Oct. 1, 2013 in preparation for the January 2014 implementation. The exchanges are meant to be marketplaces where insurance plans that meet certain federal standards compete for customers.
Former HHS official Sery Kim notes that HHS "failed to meet deadlines within the first 12 months. The fact that they have this deadline that the exchanges will be up and running in 2014 -- it's like finding a white unicorn -- it's impossible to meet that deadline.
But HHS has always insisted it will meet the deadlines and did so again in a statement to Fox News.
"We have every expectation that the Federal Marketplace will launch on schedule. Consumers can be assured that whether their state chooses to run their own Marketplace, partner with us, or have the federal government take the lead, they will be able to shop for insurance come October 2013 and will have access to coverage through a Marketplace come January of 2014," the department said.
The task facing HHS is a complicated one. The IRS has to track every American's income on a monthly basis, and then tell HHS so it knows how much each individual receives in subsidies. Then the Department Homeland Security has to be told to make sure recipients are not here illegally, among other steps.