Only 15 states have told the federal government they plan to operate health insurance exchanges under President Barack Obama’s reform law, leaving Washington with the daunting task of creating online marketplaces for two-thirds of the country.

On the eve of a federal deadline for states to say whether they will run their own exchanges, a top health care policy official told lawmakers that the exchanges will start enrolling eligible families starting on Oct. 1.

Experts say the number of states planning to operate their own exchanges could reach 18, plus the District of Columbia, by the time the deadline arrives Friday.

But the administration would still be left to set up exchanges in at least 30 states, a challenge that is raising questions about how successfully U.S. officials can implement a key provision of the health care reform law.

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