What is an exchange?

An exchange is the marketplace where insurance plans are bought and sold. States had to decide by Jan. 1 whether to have a state-operated exchange, set up a state-federal partnership or default to a federally maintained exchange.

State exchanges enable full control over operations. A partnership enables states to control some aspects of the exchange, such as managing insurance plans and assisting customers. Federal exchanges are established for states not able or willing to create their own. Only one state, Louisiana, had its application for a state-operated exchange denied.

SOURCE: Tables maintained by the Kaiser Family Foundation on state decisions on health exchanges and Medicaid expansion.