The Advisory Board Company has an updated chart on the status of state-by-state decisions on whether to implement a state-run health insurance exchange, to partner with the federal government to operate a partnership-exchange, or to choose to have a federally-run exchange operate in their state under the Patient Protection and Affordable Care Act.  While states had to declare their intent to implement a state-run exchange by December 14, they have until February 15, 2013 to decide whether to operate a partnership exchange or opt for the federally-run exchange.

In any scenario, the federal government’s responsibility for implementing health insurance exchanges has dramatically increased and it will now be  a major challenge for the Department of Health and Human Services to operate the federal exchange (requiring customization for the different Medicaid and other health insurance regulations in each state).

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