The state health insurance exchanges are a big part of the Affordable Care Act, or ObamaCare. These exchanges will function as insurance brokerages to help customers purchase health insurance that will be subsidized by federal taxpayers. As of this writing, only 18 states, including the District of Columbia, have set up exchanges. The federal government is suppose to establish an exchange for any state unwilling or unable to set up its own.
The deadline for approval of a state exchange by the federal government was January 1, 2013.