The Affordable Care Act requires each state to establish by 2014 a health insurance exchange where individuals and small businesses can purchase affordable health insurance plans. The exchanges are the centerpiece of the reform law: they will be the main portals for people without employer-sponsored or public insurance to both find a health plan and learn about and apply for any federal subsidies for which they are eligible.

To learn more about how the new insurance exchanges will work, what their impact might be, and what challenges state and federal officials face during the implementation phase, check out the following Commonwealth Fund resources:

• State Health Insurance Exchange Legislation: A Progress Report, S. R. Collins and T. Garber, The Commonwealth Fund Blog, Updated September 2011.
• State Flexibility in Risk Adjustment Under the Affordable Care Act, M. Hall, The Commonwealth Fund Blog, July 2011.
• HHS's Proposed Regulation for Health Insurance Exchanges: An Emphasis on State Flexibility, Part II, S. Collins, The Commonwealth Fund Blog,
  July 2011.  
• HHS’s Proposed Regulation for Health Insurance Exchanges: An Emphasis on State Flexibility, Part I, S. Collins, The Commonwealth Fund Blog,
  July 2011.
• State Health Insurance Exchange Legislation: A Progress Report, S. R. Collins and T. Garber, The Commonwealth Fund Blog, July 2011.
• State-Based Coverage Solutions: The California Health Benefit Exchange, M. Weinberg and L. W. Haase, The Commonwealth Fund, May 2011.
• Risk Adjustment Under the Affordable Care Act: A Guide for Federal and State Regulators, Mark A. Hall, J.D., May 2011.
• Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues, T. S. Jost, The Commonwealth Fund, September 2010.
• Health Insurance Exchanges and the Affordable Care Act: Key Policy Issues, T. S. Jost, The Commonwealth Fund, July 2010.
• Webinar on State Health Insurance Exchange Implementation, a "Realizing Health Reform's Potential" webinar cosponsored by the National Academy for State Health Policy.
• Webinar on Health Insurance Exchanges, cosponsored by the National Academy for State Health Policy and Women in Government.