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Health Insurance Exchange Decisions by State

Author: Brightmine Editorial Team

Through the creation of state-based health insurance exchanges, the Affordable Care Act (ACA) creates a competitive marketplace from which individuals and small businesses may purchase affordable health insurance.

Every state and the District of Columbia is required to have an exchange that is either:

  • Federally facilitated (operated by the US Department of Health and Human Services);
  • State-based;
  • State-based operated on the federal platform; or
  • A planned partnership with the federal government.

The following chart identifies state decisions for creating health care exchanges.