We wrote last week about the functions of the health care exchanges beginning in 2014. The actual implementation of the exchanges will occur on a state-by-state basis. Under the health care reform law, each state is authorized to establish an exchange, which can be administered by either a state governmental agency or a nonprofit organization.

Although the exchanges won’t be available to consumers and small businesses until 2014, the clock is ticking for states to lay the groundwork for their respective exchanges. If the Department of Health and Human Services (HHS) determines that a state hasn’t made sufficient progress toward establishing an exchange by January 1, 2013, or if a state chooses not to establish an exchange, HHS will step in and administer that state’s exchange.

The progress made across the country regarding the exchanges varies. For state-by-state information on the status of the exchanges, both the National Conference of State Legislatures and the Kaiser Family Foundation have websites summarizing each state’s legislative and executive activity. We’ll take a closer look at Indiana and Minnesota below, both of which are home to Faegre Baker Daniels offices.


By executive order issued in January 2011, Indiana Governor Mitch Daniels ordered the establishment of Indiana’s exchange. The order provides for the establishment of a nonprofit corporation (Indiana Insurance Market, Inc.) to serve as the exchange, with the Indiana Family and Social Services Administration in charge of establishing and operating the exchange. Information regarding Indiana’s implementation of the health care reform law can be found at www.in.gov/aca.


During 2011, the Minnesota legislature failed to act on two bills introduced to establish Minnesota’s exchange. The 2012 legislative session began in January, which provides the last opportunity for Minnesota legislators to act on authorizing legislation before the January 1, 2013 deadline approaches. Under the directive of Minnesota Governor Mark Dayton, the Health Insurance Exchange Advisory Task Force and its Technical Work Groups have been tasked with providing guidance and recommendations to the Commissioner of Commerce regarding the establishment of a Minnesota exchange.