States had the flexibility to design and operate exchanges that best met their unique needs while complying with the ACA’s statutory and regulatory standards. All the states had to make a choice regarding what kind of exchange they wanted. Basically, the states could:
• Build a fully state-based exchange;
• Default to a federal exchange (often referred to as a “federally facilitated exchange”); or
• Enter into a state partnership exchange with the federal government.
Each state had to establish an exchange where individuals can go to buy coverage, but the states also had to set up Small Business Health Options Programs (SHOPs or SHOP exchanges) where small businesses can purchase coverage.
Kansas decided to default to a federally facilitated exchange. Kansas did receive approval from the Center for Consumer Information and Insurance Oversight (CCIIO) to perform plan management activities, but the federal government will retain control over all other exchange functions. Therefore, consumers in Kansas will use HealthCare.gov to apply for coverage, compare plans, and enroll.