Exchanges are entities that function as a marketplace for buyers of health insurance, giving them options and prices for health coverage. The Affordable Care Act requires health insurance exchanges to be established and working in every state. The ACA gives states the option to establish one or more state or regional exchange(s), or partner with the federal government to run certain functions of the exchange. If a state chooses not to create an exchange, the federal government will set up the exchange(s) in the state. Seventeen states are running their exchanges, seven have partnered with the federal government and the others have deferred to the federal government to run them. These decisions can be changed by states in 2015 or beyond.
NEWS: On Nov. 15, 2014 exchanges opened again for second year enrollment; small business (SHOP) exchanges contiue to offer policies through 2015, including incentives up to 50% for certain businesses with up to 25 FTE employees offering first-time coverage. [NCSL Online report updated 11/17/2014]