NUMBER OF UNINSURED: 1.27 million Michigan residents are uninsured, about 13 percent of the population.

WHERE THE STATE STANDS: The Department of Licensing and Regulatory Affairs has been working to set up a health insurance exchange, but has had limited success because House Republicans refuse to let it use $9.8 million in federal planning dollars. Because of looming federal deadlines to have an exchange in place, state officials are planning for a state-run exchange while also talking to federal officials about partnering with a federal exchange where the state handles just some responsibilities, such as customer service.

WHAT HAPPENS NOW: If the health insurance exchange is upheld by the U.S. Supreme Court, state officials hope the House will approve spending the $9.8 million when it returns to session July 19. In the meantime, the state will try to apply for more federal funds so it can get the exchange up and running, whether on its own or with the federal government. If the exchange is struck down, Republican Gov. Rick Snyder, who has previously expressed support for the idea of a health insurance exchange, says he's more likely to focus on wellness initiatives than pursuing a state exchange option.