Health Insurance Exchanges are new organizations that will be set up to create a more organized and competitive market for buying health insurance for individuals and businesses. Health Insurance Exchanges will offer a choice of different health plans, certifying plans that participate and providing information to help consumers better understand their options.

About Health Insurance Exchanges

Beginning in 2014, Health Insurance Exchanges (HIX or HIEx) will serve primarily individuals buying insurance on their own and small businesses with up to 100 employees, though states can choose to include larger employers in the future. States can create multiple Health Insurance Exchanges, so long as only one serves each geographic area, and can work together to form regional Health Insurance Exchanges.

Health insurance sold to American consumers and businesses on the health insurance exchanges will be exclusively provided by private insurance companies. The “individual mandate requirement” of the health reform law stipulates that all individuals (adults and children) must purchase health insurance coverage.

History of Health Insurance Exchanges

President Obama promoted the concept of health insurance exchanges as a key component of his health reform initiative, the Patient Protection and Affordable Care Act (PPACA), commonly referred to as Obamacare. President Obama stated that health insurance exchanges should be,

“[A] market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that’s best for them, in the same way that Members of Congress and their families can. None of these plans should deny coverage on the basis of a preexisting condition, and all of these plans should include an affordable basic benefit package that includes prevention, and protection against catastrophic costs.”

Ideally, health insurance exchanges will help insurers comply with consumer protections, compete in cost-efficient ways, and facilitate the expansion of insurance coverage to more people.

Links to State Health Insurance Exchanges

Every State is expected to establish a Health Insurance Exchange available for use by open enrollment beginning October 1, 2013, or sooner. The federal government will offer technical assistance and money grants to help states set up Health Insurance Exchanges. If a State chooses not to establish a Health Insurance Exchange (or is unable to provide a Health Insurance Exchange), the federal government will step in and establish a Health Insurance Exchange for residents.

As of April 1, 2013, here are the cumulative state decisions for creating health insurance exchanges:

  • 18 Declared State-Run Health Insurance Exchanges (Hawaii, Idaho, Kentucky, New York, Rhode Island, Utah, Vermont, California, Colorado, Connecticut, District of Columbia, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, Oregon, Washington).
  • 7 Planning for State-Federal Partnership Health Insurance Exchanges (Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, West Virginia).
  • 26 Default to Federal-Run Health Insurance Exchanges (Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin, Wyoming).

For more information on health insurance exchanges in your state, follow the links below.

Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming

Follow the progress of each State on creating their health insurance exchanges under the Affordable Care Act (aka, Obamacare) and what those exchanges may look like through the Exchange Monitor, featuring new data on Statehealthfacts.org.