The Affordable Care Act allows states to create their own state-based health insurance exchanges or to allow a federally facilitated exchange to operate in the state. Proposed rules from the Department of Health and Human Services (HHS) also allow a partnership model where the federal and state governments share in the execution of exchange functions.
State Affordable Insurance Exchanges (exchanges) are at the core of the coverage reform in the Affordable Care Act (ACA). The exchanges establish a marketplace in which individuals and small employers can compare and select among affordable, quality health insurance options.
An estimated 27 million people will gain coverage through Medicaid or private qualified health plans via the new health insurance exchanges once the Affordable Care Act (ACA) is fully implemented in 2014. It is estimated that a significant percentage of those obtaining coverage will have income fluctuations that will change their eligibility status between public and private coverage options offered through the exchanges.