Health Insurance Exchanges: Which Option Did Each State Choose?

Written by Jim McLaughlin | February 18, 2013

Becker’s Hospital Review


Friday was the deadline for states to apply to run part of their own health insurance exchange or cede all control and oversight on the online marketplaces to the federal government by default.

States opting to build and operate their own exchange had until Dec. 14, 2012, to submit their proposed plan to HHS. With a few exceptions, most Republican governors have balked at implementing the online marketplaces, which are key elements of the Patient Protection and Affordable Care Act, and have punted that task onto the feds.

Federal regulators will run all or part of the exchanges for more than half the states. Here is the status of each state’s health insurance exchange, as of last week’s deadline. Note: Data is based on data from consulting firm Avalere Health.

— Federally operated exchange
Gov. Robert Bentley, MD (R)    

Alaska — Federally operated exchange    
Gov. Sean Parnell (R)

Arizona — Federally operated exchange
Gov. Jan Brewer (R)

Arkansas — Federal-state partnership
Gov. Mike Beebe (D)

California — State-run exchange
Gov. Jerry Brown (D)

Colorado —     State-run exchange
Gov. John Hickenlooper (D)

Connecticut — State-run exchange
Gov. Dan Malloy (D)

Delaware — Federal-state partnership
Gov. Jack Markell (D)

District of Columbia — District-run exchange
Mayor Vincent Gray (D)

Florida — Federally operated exchange
Gov. Rick Scott (R)

Georgia — Federally operated exchange
Gov. Nathan Deal (R)

Hawaii — State-run exchange
Gov. Neil Abercrombie (D)

Idaho — State-run exchange
Gov. Butch Otter (R)

Illinois — Federal-state partnership    
Gov. Pat Quinn (D)

Indiana — Federally operated exchange
Gov. Mike Pence (R) (Mitch Daniels previously)

Iowa — Federal-state partnership    
Gov. Terry Branstad (R)

Kansas — Federally operated exchange
Gov. Sam Brownback (R)

Kentucky — State-run exchange
Gov. Steve Beshear (D)

Louisiana — Federally operated exchange    
Gov. Bobby Jindal (R)

Maine — Federally operated exchange    
Gov. Paul LePage (R)

Maryland — State-run exchange
Gov. Martin O’Malley (D)

Massachusetts — State-run exchange
Gov. Deval Patrick (D)

Michigan — Federal-state partnership
Gov. Rick Snyder (R)

Minnesota — State-run exchange
Gov. Mark Dayton (D)

Mississippi — Federally operated exchange
Gov. Phil Bryant (R)

Missouri — Federally operated exchange
Gov. Jay Nixon (D)

Montana — Federally operated exchange
Gov. Steve Bullock (D) (Brian Schweitzer previously)

Nebraska — Federally operated exchange
Gov. Dave Heineman (R)

Nevada — State-run exchange
Gov. Brian Sandoval (R)

New Hampshire — Federal-state partnership
Gov. Maggie Hassan (D) (John Lynch previously)

New Jersey — Federally operated exchange
Gov. Chris Christie (R)

New Mexico — State-run exchange
Gov. Susana Martinez (R)

New York — State-run exchange
Gov. Andrew Cuomo (D)

North Carolina — Federally run exchange
Gov. Pat McCrory (R) (Bev Purdue previously)

North Dakota — Federally operated exchange
Gov. Jack Dalrymple (R)

Ohio — Federal-state partnership *   
Gov. John Kasich (R)

Oklahoma — Federally operated exchange
Gov. Mary Fallin (R)

Oregon — State-run exchange
Gov. John Kitzhaber, MD (D)

Pennsylvania — Federally operated exchange
Gov. Tom Corbett (R)

Rhode Island — State-run exchange
Gov. Lincoln Chafee (I)

South Carolina — Federally operated exchange
Gov. Nikki Haley (R)

South Dakota — Federal-state partnership    
Gov. Dennis Daugaard (R)

Tennessee — Federally operated exchange    
Gov. Bill Haslam (R)

Texas — Federally operated exchange
Gov. Rick Perry (R)

Utah — State-run exchange **
Gov. Gary Herbert (R)

Vermont — State-run exchange
Gov. Peter Shumlin (D)

Virginia — Federal-state partnership *
Gov. Bob McDonnell (R)

Washington — State-run exchange
Gov. Jay Inslee (D) (Christine Gregoire previously)

West Virginia — Federal-state partnership *
Gov. Earl Ray Tomblin (D)

Wisconsin — Federally operated exchange
Gov. Scott Walker (R)

Wyoming — Federally operated exchange
Gov. Matt Mead (R)

*Pending HHS approval

**Utah has requested HHS approve its existing health insurance exchange for small businesses called Avenue H. HHS has stated they will work to assist the state to come into full compliance with the health law, but have not yet fully approved Utah’s proposal.

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