Health Policy Tracker

Exchanges, State by State

By Jan. 1, 2014, the Affordable Care Act will require all states to either create a state or regional health benefits exchange or allow the federal government to do it for them. The map below tracks their progress, as well as any legal challenges they may be mounting against the law itself. Click on any state for more information.

Click a state for more information

Sources: HHS, Kaiser Family Foundation, and the National Conference of State Legislatures

Key dates in health care reform

Feb. 25, 2010

President Obama hosts a bipartisan meeting with members of Congress to discuss health reform legislation. With Obama are Secretary of Health and Human Services Kathleen Sebelius and Senate Minority Leader Mitch McConnell. (Photo: Saul Loeb/AFP)

March 4, 2010

HHS Secretary Sebelius meets with insurance industry executives and officials at the White House. Sebelius called the meeting after WellPoint Inc., the largest health insurance company by membership, proposed a 39 percent rate increase for some policyholders in California. (Photo: Brendan Hoffman/Bloomberg)

March 23, 2010

President Obama signs the Affordable Health Care for America Act during a ceremony with fellow Democrats in the White House. The landmark bill was passed by the House of Representatives after a 14-month-long political battle that left the legislation without a single Republican vote. (Photo: Chip Somodevilla/Getty Images)

June 22, 2010

President Obama speaks at an event marking the 90-day anniversary of the signing of the Affordable Care Act. Shortly afterwards, he announced the release of new regulations implementing the patients' bill of rights protections included in the act. (Photo: Chip Somodevilla/Getty Images)

Sept. 23, 2010

HHS establishes interoperable standards and protocols for enrollment in federal and state HHS programs.

Sept. 30, 2010

State planning grants awarded.

March 3, 2011

HHS Secretary Sebelius is greeted by House Health Subcommittee Chariman Joe Pitts, R-Penn., and Rep. Henry Waxman, D-Calif. Sebelius testified on the budget and the implementation of health care reform laws, including the Patient Protection and Affordable Care Act. (Photo: Chip Somodevilla/Getty Images)

March 17, 2011

Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services, packs up his things after testifying during the Senate Health, Education, Labor and Pensions hearing on the status of the Affordable Care Act after one year. (Photo: Scott J. Ferrell / CQ Roll Call Group)

March 21, 2011

Planning grants are established for the US territories (American Samoa, Guam, Puerto Rico, and the US Virgin Islands).

March 22, 2011

HHS makes grants available for the planning and development of state and local health benefits exchanges.

March 23, 2011

HHS to develop standards for compiling and providing enrollees with a summary of benefits and coverage explanations.

Jan. 1, 2013

HHS to approve that states will be willing and able to implement their exchanges by Jan. 1, 2014.

July 1, 2013

HHS to provide loans to assist with start-up costs for co-ops.

Jan. 1, 2014

Deadline for state health exchanges to become operational.