State insurance exchanges form a central part of healthcare reform under the Affordable Care Act (ACA). Beginning in 2014, nearly every individual who is not covered under through an employer or government plan much purchase insurance or be subject to a penalty. State insurance exchanges will provide competitive marketplaces for individuals and small employers to directly compare and purchase private health insurance options based on price, quality and other factors.
In order to allow time for individuals to shop for and purchase insurance by the January 1, 2014 deadline, state insurance exchanges must be operational by October 1, 2013.
Although a few states moved quickly to establish an exchange, many states waited until after the Supreme Court ruling upholding the individual mandate and even after November election to decide on whether to establish an exchange. Further, the Department of Health and Human Services (HHS) has been slow to release the necessary regulations.
However, with the deadline for decisions looming this week, momentum is building.