On March 11, the Commonwealth Fund released an article examining California's health coverage exchange.  Required under the national health care reform law, California was the first state to subsequently approve legislation to implement an exchange.  The article outlines the exchange's role and raises questions and challenges facing its implementation.

From the report: 

California's urgent focus on addressing its state budget shortfall has posed a challenge, since the state will need to make rapid progress on exchange implementation to meet its goals and the Affordable Care Act's requirements. "The two biggest challenges California faces in implementation are the aggressive timeline and the state's fiscal situation. We must ensure the exchange does not create a direct or indirect burden on the state treasury," said Maxwell-Jolly. The state emphasized that because the Affordable Care Act's requirements for exchanges are complex, it is critical to promote consistent and open communication among all stakeholders to ensure that everyone fully understands the exchange provisions, as a foundation for collaboration to develop the exchange. 

Full report: California First with Exchange Legislation Under National Reform

The Commonwealth Fund.  (2010).  California first with exchange legislation under national reform.