State-by-State Decisions on Health Insurance Exchanges: 50 Statistics on Plans for 2014
States have the option of establishing the exchange as part of an existing state agency or office, as an independent public agency, or as a non-profit entity. They also have flexibility in determining the role of the exchange with respect to contracting with health plans. All exchanges must contract only with health plans that meet federal requirements for qualified health plans. They can choose to have the exchange contract with all qualified health plans (clearinghouse) or with selected health plans (active purchaser).
Default to federal exchange
States that default to federal exchange have indicated that they will default to a federally-facilitated exchange rather than planning their own model.
1. North Dakota
2. South Dakota
12. South Carolina
13. New Hampshire
Planning for partnership exchange
These states have indicated they will partner with the federal government to operate an exchange.
5. North Carolina
Declared state-based exchange
These states have declared their intentions to establish their own insurance exchanges. "Active purchaser" means that the state will set up the exchange contract with selected health plans and/or negotiate premium prices with health plans. "Clearinghouse" means the state will set up the exchange contract with all qualified health plans. States with no indication either way have not addressed the issue yet.
2. Oregon (Active purchaser)
3. California (Active purchaser)
4. Nevada (Clearinghouse)
5. New Mexico
6. Colorado (Clearinghouse)
10. New York
11. Vermont (Active purchaser)
12. Connecticut (Active purchaser)
13. Rhode Island (Active purchaser)
14. Massachusetts (Active purchaser)
15. Maryland (Clearinghouse)
17. Hawaii (Clearinghouse)
These states have not yet indicated whether they will operate a state-based exchange or state-federal partnership exchange, or default to federally-facilitated exchange.
10. West Virginia
13. New Jersey
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