As states develop insurance exchanges, their decisions have profound implications for consumers. This report covers three main areas where consumers intersect with the exchange. First are ways consumers participate in exchange governance, such as directly serving on exchange governing boards. Second is consumer input into exchange policy and implementation decisions, and the various avenues states are using to gather this input, such as workgroups, town hall meeting participation, and surveys. Third is the early planning for the consumer-serving functions of the exchange, such as navigator programs and the web portal.