The Kaiser Family Foundation (KFF) has released a brief examining states’ progress towards implementing the health insurance exchanges required under national health care reform.  The brief examines challenges states face and summarizes early trends in exchange governance, structure, and financing.  The U.S. Department of Health and Human Services (HHS) recently issued regulations giving states until January 1, 2013 to demonstrate their ability to operate a functional exchange.  To date, more than a third of states have begun working towards implementation.  Required in every state by January 1 2014, HHS will operate exchanges in states that are unprepared or unwilling to operate their own.

From the report:

State-based health insurance exchanges are a key component of the Patient Protection and Affordable Care Act (ACA) of 2010, facilitating expanded access to coverage for millions of individuals and employees of small businesses. The health insurance exchanges, scheduled to be operational by January 2014, are intended to enable consumers to readily compare qualified health insurance options in order to select plans that best meet their needs. They will also be the mechanism through which low and moderate-income individuals receive premium and cost-sharing subsidies to make health coverage more affordable. The ACA allows states great latitude in how they design their exchanges, giving them flexibility over such things as how the exchange is structured, how it is governed, and how it certifies and contracts with health plans. If a state chooses not to create its own exchange, the federal government will operate one in the state. By 2019, the Congressional Budget Office estimates that over 24 million people will enroll in a health plan purchased through an exchange.

Full report: Establishing Health Insurance Exchanges: An Update on State Efforts (PDF | 394.49 KB)

Kaiser Family Foundation.  (2011).  Establishing health insurace exchanges: an update on state efforts.