This issue brief presents key implementation and data considerations for states as they contemplate the creation and role of health insurance exchanges.  Establishing health insurance exchanges is integral to implementing reforms under the Patient Protection and Affordable Care Act (ACA).  Exchanges are government-regulated insurance marketplaces designed to increase access to and facilitate purchase of affordable health insurance for certain subpopulations, including individuals (non-group market) and small businesses (small group market)

This brief also profiles four state exchanges launched under state health reform efforts that predated the ACA: Massachusetts Health Connector, Utah Health Exchange, Connecticut Business and Industry Association (CBIA) Health Connections, and Washington Health Insurance Partnership (HIP).