state of implementation
Exchange Governance Chart
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.
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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.