How is a federal-state partnership different from a federal or state exchange?

Q. My state exchange is a federal-state partnership. How is that different from a federal-run or state-run exchange?

A. Six states have opted for a partnership exchange with the federal government (Delaware, Illinois, Iowa, Michigan, New Hampshire, West Virginia). A seventh, Arkansas, had a state-federal partnership exchange until 2017, but switched at that point to having a state-run exchange that uses the HealthCare.gov enrollment platform.

The partnership exchange is essentially a federally-run exchange with varying degrees of input, regulation and oversight from the state’s Department of Insurance. The specifics are different in each state, as HHS has given states a lot of leeway in determining what aspects of a partnership exchange should be state-run. All of the state-federal partnership exchanges use the federally-run enrollment platform at HealthCare.gov.

The goal of the partnership exchanges is to utilize the efficiency of a federally run exchange while giving states a broad scope of authority over the day-to-day running of the exchange and interface with insurers and consumers. From a consumer perspective, the whole thing should be seamless and efficient, and you won’t notice that the oversight of the exchange is divided between the state and federal governments. You’ll be working with local navigators and other exchange personnel who are hired by the exchange and trained on the specific details about the plans that will be available in your state.

If you’re interested in the specific details of which entity run the various parts of the partnership exchanges, this HHS bulletin has a lot of information. And this page shows what type of exchange model each state is using.

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health insurance exchange

health insurance marketplace

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