Employers
are
not
directly
affected
by
the
establishment
of
state
insurance
exchanges
under
health
care
reform,
but
understanding
the
exchange
landscape
helps
clarify
the
bigger
picture
of
health
care
reform
and
how
employers
fit
within
that.
So
here's
where
we
are
today:
The
deadline
ran
last
Friday
for
states
to
file
applications
to
run
an
exchange
in
partnership
with
the
federal
government
for
2014.
Some
did
that,
but
as
I've
written
about
previously
(here),
the
response
has
been
underwhelming.
States
that
do
not
have
their
own
exchanges
and
do
not
partner
with
the
federal
government
will
default
to
having
a
federally
facilitated
exchange.
The
Kaiser
Family
Foundation
has
an
interesting
graphic
(here)
that
illustrates
what's
going
on
in
each
state.
It
reflects
that
only
17
states
(plus
the
District
of
Columbia)
will
run
their
own
exchanges,
7
states
will
have
partnership
exchanges,
and
26
states
will
default
to
the
federal
exchange.
Depending
on
your
political
view,
that's
either
a
good
first
step
toward
national
uniformity
in
the
health
insurance
market
or
a
lot
of
federal
involvement.
Either
way,
a
lot
of
questions
remain,
including
whether
and
how
these
exchanges
will
be
fully
functional
by
October
(when
they
need
to
begin
enrollment
for
2014)
and
what
the
exchange
interface
will
look
like.
The
federal
government
continues
to
believe
it
is
on
track
(see
here),
but
there
is
a
lot
of
ground
to
cover
between
now
and
then.