This report from the National Academy for State Health Policy reviews the language of the Affordablel Care Act to provide the basic requirements of the state healh insurance exchanges. The report does note that such requirements will be supplemented by regulations defined by the Secretary of the Department of Health and Human Services. As such, the interpretation of these requirements may change, and constituents should continue to look for guidance from the Department of Health and Human Services.

From the report: 

State-based health insurance exchanges play a central role in implementation of the Patient Protection and Affordable Care Act. Exchanges are intended to simplify and structure health insurance choices for individuals, families, and small businesses, while they will be the exclusive mechanism for people to apply their federal premium assistance tax credits toward the cost of insurance coverage.

The purpose of this brief is to set forth the major requirements for exchanges as described in the federal law. These requirements provide states with sufficient guidance to define the overall parameters of their exchanges, recognizing that states will likely revisit or refine these decisions as the federal law is clarified through federal regulations.

Full Report: Health Insurance Exchange Basics (PDF | 126 KB) 

National Academy for State Health Policy. (2011). Health insurance exchange basics. Weil, A., Shafir, A., and Zemel, S.