Executive Orders and Laws

Existing Exchange, Executive Orders, and Passed Laws

Ecacted Legislation

California

California - UCLA Issue Briefs on Exchange Population
UCLA has prepared this policy brief outlining the likely make up of the exchange population. According to the brief, California had approximately 1.7 million nonelderly uninsured in 2009 who will become eligible for coverage on the exchanges. This brief breaks down the demographics of that population and outlines potential issues and implications of the new market.
May 2011

California - UCLA Issue Briefs on Exchange Population
UCLA has prepared this policy brief outlining the likely make up of the Medi-Cal population. According to the brief, California had approximately 2.3 million nonelderly uninsured in 2009 who will become eligible for coverage on through Medi-Cal. This brief breaks down the demographics of that population and outlines potential issues and implications of the expanded Medicaid eligibility in California.
May 2011

California - Health Exchange Overview
The Advisor for Health Care Reform Implementation to the California Health and Human Services Agency has prepared an overview presentation of the recently enacted California Health Exchange.
November 2010

California - Health Benefits Exchanges
Governor Arnold Schwarzenegger signed Legislation into law creating the California Health Insurance Exchange. 
October 2010

Colorado

Colorado - Senate Bill 11-200
The Colorado Senate has passed a bill to establish a health insurance exchange. SB 11-200 creates a 9 member board, its responsibilities, and authority. The Governor's press release on SB 11-200 can be found here. 
May 5

Colorado - Stakeholder Persepcitves
Colorado's Office of Health Care Reform Implementation held 5 stakeholder meetings between August and September 2010. These are a summary of the stakeholder persepectives. 
October 2010

Colorado -Grant application and proposal
Colorado passed an expansion for plans and access during the 2009 legislative session. The Health Care Implementation Board has prepared an exchange planning grant proposal which includes recommendations for exchange governance, plan options, and structure.
October 2010

Hawaii

Hawaii - Health Connector
Governor Neil Abercrombie signed SB 1348 establishing the Hawaii Health Connector. The law was drafted to be compliant with the ACA. The Hawaii Health Connector is a nonprofit governed by a board appointed by the governor and approved by the state senate.
July 2011

Maryland

Maryland - Health Insurance Exchange Law
Governor Martin O'Malley signed SB 182 establishing the Maryland Health Insurance Exchange as a public corporation. 
April 2011

Maryland - Health Care Reform Coordinating Council
The Maryland Depart of Health and Mental Hygiene has established a coordinating council charged with developing recommendations for PPACA's implementation, and implementation of state exchanges. The council prepared the state's exchange grant application. As part of the implementation process, the Maryland State Health Reform Coordinating Council prepared this report on PPACA's provisions and made recommendations for implementation of PPACA
July 2010

Massachusetts

MassachusettsHealth Connector
Massachusetts passed heath care reform which included a health benefits exchange called the Connector. 
August 2006

Massachusetts Health Care Reform
This is a summary of the Massachusetts Conference Committee Report establishing that state's health care reform law. This law includes similar provision to PPACA including individual and employer mandates and a health benefits exchange.
April 2006

Nevada

Nevada – Silver State Exchange
Nevada created the Silver State Exchange in SB 440. The Silver State Exchange is a non-profit entity governed by a seven-member board of directors; five members appointed by the governor and one appointed by the senate majority leader and by the Speaker of the Assembly.

Oregon

Oregon - Health Insurance Exchange Legislation
The House Health Committee sponsored HB 3137, the bill directs the Oregon Health Authority to establish the Oregon Health Insurance Exchange. The bill lays out governance and funding recommendations.
February 2011

Oregon - State Policy Recommendations
The Oregon Health Policy Board voted on October 12 to structure the state's insurance exchange as a "not-for-profit public corporation with a strong consumer-oriented mission, governing board and consumer advisory board." The board also recommended the exchange's governing be made up of between 9-11 members nominated by the Governor and confirmed by the Oregon Senate. Meeting documents are not yet available.
October 2010

Utah

Utah Health Exchanges
Utah established a health insurance exchange August 2009. The Utah health insurance exchange initially opened to small employer groups and expanded to individual and family plans. The exchange website can be found here.
August 2010

Washington

Washington - Health Exchange Law
Governor Gregoire (D) signed SB 5445 making Washington the fifth state to establish a health insurance exchange. 
April 2011

Washington - Health Care Cabinet
Governor Christine Gregoire (D) created a Health Care Cabinet to develop recommendations and advise on issues of health care reform and implementation. 
February 2011

Washington - Joint Selective Committee on Health Reform Implementation
The Washington State Legislature created a joint select committee to develop recommendations for PPACA's implementation. The Committee met four times in 2010 to develop recommendations for PPACA's implementation in Washington State. The Committee issued its final report in November 2010. The joint committee's website includes issue briefs on exchange structure, exchange administration, and risk within the exchange. 
November 2010

West Virginia

West Virginia – Health Benefit Exchange
Governor Earl Ray Tomblin signed SB 408 creating the West Virginia Health Benefit Exchange within the office of the Insurance Commissioner. The exchange will be governed by a board of directors made of four members appointed by the governor; one member represents the interests of payers. 

Exchange Proposals and Legislation

Arizona

Arizona – HB 2666 and SB 1524
Bills were introduced in the Senate and House both bills failed to pass out of committee.

District of Columbia

District of Columbia - Health Care Exchange
The District of Columbia is currently considering legislation to establish their exchange within the Department of Health Care Finance. The Exchange will be governed by a board appointed by the Mayor, Director of the Department of Health Care Finance, and the city council.

 Georgia

Georgia - House Health Insurance Exchange Authority bill
The Georgia House of Representatives has introduced a bill that would create a health exchange and SHOP exchange. 
March 2011

Georgia - State Planning and Establishment Grants for the Affordable Care Act’s Exchanges
The Governor’s Office of Planning and Budget prepared the state's grant application narrative which outlines governance, structure and other administrative procedures for Georgia's health insurance exchange.
August 2010

Maine

Maine – Study Committee
Maine failed to pass companion bills establishing a health insurance exchange. The legislature has passed a study committee, which has reported to the legislature.

Montana

Montana - Compromise Exchange Legislation
The Montana State House of Representatives has introduced another bill in an attempt to establish a health insurance exchange. This bill would establish an online venue to sell coverage. 
March 2011

Montana - Exchange Legislation
The Montana Commissioner of Securities and Insurance has filed legislation establishing health insurance exchanges. This legislation is based on committee meetings of the Montana Exchange Stakeholder Involvement Council. A summary of the introduced bill can be found here.
January 2011

Minnesota

Minnesota – HF 497 and HF 1204
Bills were introduced in the House both bills failed to pass out of committee.

New Mexico

New Mexico - Vetoed Exchange Bill
Governor Martinez (R) vetoed SB 38/370 which would have established a health insurance exchange in New Mexico. 
April 2011

New York

New York – Governor’s Program Bill and S05652
Governor Cuomo introduced a program bill that included language establishing a health insurance exchange and another bill was introduced in the Senate, both bills failed to pass.

Ohio

Ohio - Planning Grant Narrative
Ohio has applied for exchange planning grants. Along with their narrative, Ohio submitted a timeline and work plan they wish to follow for implementation.
October 2010

Pennsylvania

Pennsylvania - SB 940 and HB 627
Pennsylvania currently has two bills pending in the legislature. SB 940 and HB 627 both establish health insurance exchanges within the state insurance department.

Texas

Texas – SB 1782, SB 1510, SB 1586, and HB 636
Four bills were introduced in Texas establishing a health benefits exchange, all failed to garner support.

Wisconsin

Wisconsin - Office of Free Market Health Care
Governor Scott Walker (R) issued an executive order creating the Office of Free Market Health Care. The office will directed by the Department of Health Services and the Commissioner of Insurance.
January 2011 

Wisconsin - Special Committee on Health Care Reform 
The committee's web page includes an exchange project summary and presentations on the Massachusetts Connector prepared by Jon Kingsdale, Ph.D. 
January 2011

Wisconsin - Office of Health Care Reform Implementation 
Wisconsin established the state's Office of Health Care Reform under former Governor Jim Doyle (D). The authority is charged with developing the state's health insurance exchange. The Wisconsin Office of Health Care Reform outlines PPACA implementation efforts and provides a prototype of the state's health insurance exchange.
October 2010

Wisconsin - Office of Health Care Reform Implementation 
Wisconsin established the state's Office of Health Care Reform under former Governor Jim Doyle (D). The authority is charged with developing the state's health insurance exchange. The Wisconsin Office of Health Care Reform outlines PPACA implementation efforts and provides a prototype of the state's health insurance exchange. 
October 2010