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Maria Webster joins others protesting Texas Gov. Rick Perry's stance on health care outside the state capitol in Austin, Texas. (AP Photo/Eric Gay, File)

WASHINGTON (AP) — Three years, two elections, and one Supreme Court decision after President Barack Obama signed the Affordable Care Act, its promise of health care for the uninsured may be delayed or undercut in much of the country because of entrenched opposition from many Republican state leaders.

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