This chart highlights steps states have taken to create an exchange. If you’d like to read more about exchange policy decisions, check out our State and Partnership Exchange Policy Decisions chart.
Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content.
Know of something we should add to this compilation? Eager to update a fact we’ve included? Your feedback is central to our ongoing, real-time analytical process, so tell us in a comment, or email the author with your suggestion. She can be reached at firstname.lastname@example.org.
|State1||Level 1 or 2 Establishment Grant2||Exchange Established3||Exchange Design||Exchange Governance||Exchange Director||Exchange Board Appointed3|
|AK||Federally facilitated exchange|
|AL||Level 1||Federally facilitated exchange|
|AR||Level 1||Partnership exchange||Cynthia Crone|
|AZ||Level 1||Federally facilitated exchange|
|Level 1||Legislation||State-based exchange||Independent public agency||Peter V. Lee||Yes|
|CO||Level 1||Legislation||State-based exchange||Quasi-governmental entity||Patty Fontneau||Yes|
|CT||Level 1 and Level 2||Legislation||State-based exchange||Public non-profit corporation||Kevin Counihan||Yes|
|DE||Level 1||Partnership exchange||Michelle Amadio|
|DC||Level 1 and Level 2||Legislation||State-based exchange||Independent authority that is legally separate from the DC government. Housed at Department of Health Care Finance.||Mila Kofman||Yes|
|FL||Federally facilitated exchange|
|GA||Federally facilitated exchange|
|HI||Level 1||Legislation||State-based exchange||Private non-profit entity||Tom Matsuda||Yes|
|IA||Level 1||Partnership exchange|
|Level 1||Legislation||State-based exchange||Independent public corporation||Amy Dowd||Yes|
|IL||Level 1||Partnership exchange||Jennifer Koehler|
|IN||Level 1||Federally facilitated exchange|
|LA||Federally facilitated exchange|
|KS||Federally facilitated exchange|
|Level 1||Executive Order||State-based exchange||New office within the Cabinet for Health and Family Services||Carrie Banahan|
|MA||Level 1||Legislation||State-based exchange||Quasi-governmental entity||Jean Yang||Yes|
|Level 1||Federally facilitated exchange|
|Level 1 and Level 2||Legislation||State-based exchange||Quasi-governmental entity||Carolyn Quattrocki||Yes|
|MI||Level 1||Federally facilitated exchange|
|Level 1||Legislation||State-based exchange||State board||Scott Leitz||Yes|
|MO||Level 1||Federally facilitated exchange|
|MS||Level 1||State-based SHOP; Federally facilitated individual exchange||Within the existing CHIRPA, which is a nonprofit entity.||Not applicable4|
|MT||Federally Facilitated Exchange|
|NC||Level 1||Federally facilitated exchange|
|ND||Federally facilitated exchange|
|NE||Level 1||Federally facilitated exchange|
|NJ||Level 1||Federally facilitated exchange|
|NM||Level 1||Legislation||State-based SHOP; Federally facilitated individual exchange||Nonprofit public coroporation||Mike Nunez||Yes|
|NV||Level 1 and Level 2||Legislation||State-based exchange||Individual public entity||Yes|
|NY||Level 1||Executive Order||State-based exchange||Within the existing Health Department||Donna Frescatore||Not applicable|
|OH||Federally facilitated exchange|
|OK||Federally facilitated exchange|
|OR||Level 1||Legislation||State-based exchange||Public Corporation||Bruce Goldberg||Yes|
|PA||Level 1||Federally facilitated exchange|
|RI||Level 1 and Level 2||Executive Order||State-based exchange||New division within the executive branch||Christine Ferguson||Yes|
|SC||Federally facilitated exchange|
|SD||Level 1||Federally facilitated exchange|
|TN||Level 1||Federally facilitated exchange|
|TX||Federally facilitated exchange|
|UT||Legislation||State-based SHOP; Federally facilitated individual exchange||Department within Office of Consumer Health Services||Patty Connor||Not applicable5|
|VA||Federally facilitated exchange|
|VT||Level 1 and Level 2||Legislation||State-based exchange||Within the existing Department of Vermont Health Access||Lindsey Tucker||Not applicable6|
|WA||Level 1 and Level 2||Legislation||State-based exchange. Option to become regional exchange later on.||Non-governmental, public/private entity||Richard Onizuka||Yes|
|WI||Federally facilitated exchange|
|WV||Level 1||Legislation||Partnership exchange|
|WY||Federally facilitated exchange|
|Total||35||15 +DC7||16 state based exchanges, 27 federally facilitated exchanges, 6 partnership exchanges, 3 state SHOP only exchanges||n/a||18||14|
1 State abbreviations are linked to exchange websites, where available.
2 For more information on state exchange establishment grants check out our chart and the full list from HHS.
3 For more in-depth analysis of state exchange legislation and board composition, check out our legislation chart.
4 CHIRPA is governed by a nine-member board.
5 Risk adjuster board sets policies related to defined contribution market but does not oversee operations.
6 The Exchange is administered by the Department of Vermont Health Access in consultation with the Medicaid and Exchange Advisory Committee.
7 Total includes Massachusetts, which created the Connector in 2006, prior to the ACA.