WASHINGTON (January 22, 2012)--An Associated Press analysis shows that three out of four uninsured Americans live in states that haven't finalized plans for affordable medical care.

This year will make or break the health overhaul. States were supposed to be partners, putting in place the biggest safety net expansion since Medicare and Medicaid, but the AP analysis, combined with estimates from the nonpartisan Urban Institute, shows that states are moving in fits and starts.

The 13 states that have adopted a plan are home to only 1 in 4 of the uninsured.

Seventeen other states are making headway, but it's not clear all will succeed.

The 20 states that lag behind account for the biggest share of uninsured at 42 percent.