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Below is a brief guide of healthcare exchanges by state. This information will help you understand health insurance exchange states as they are today and provide some guidance on how to access the correct insurance exchange shopping platform for your state.

Health Insurance Exchange States by Type1

Heath insurance exchange states fall into one of four categories: a State-Based Marketplace, Federally-Supported State-Based Marketplace, State-Partnership Marketplace, or Federally-Facilitated Marketplace.

State-Based Marketplace: States establish and run their own marketplace. Consumers enroll in coverage through a state-maintained website. States include: CA, CO, CT, DC, ID, MD, MA, MN, NV, NJ, NY, PA, RI, VT, and WA.

Federally-Supported State-Based MarketplaceStates establish and run their own marketplace. However, consumers enroll in coverage through the Federal website. States include: AR, KY, ME, NM, OR, and VA.

State-Partnership MarketplaceThese states share responsibility with the federal government. They administer some in-person consumer assistance, while remaining functions are performed by the US Department of Health and Human Services. Consumers use to enroll.  States include: DE, IL, IA, KS, MI, MT, NE, NH, OH, SD, UT, and WV.

Federally-Facilitated MarketplaceUS Department of Health and Human Services performs all marketplace functions and consumers enroll through States include: AL, AK, AZ, FL, GA, HI, IN, LA, MS, MO, NC, ND, OK, SC, TN, TX, WI, and WY.

Roughly 36 health insurance exchange states rely on the federal website for sign-up and enrollment.  States are likely to continue to evolve and change platforms. For instance, Delaware had a federally-facilitated marketplaces, but switched to a state-partnership marketplace system similar to Illinois. Nevada moved to state exchange beginning in 2020.

Whether you’re a resident of California or Texas, HealthMarkets is here to help you understand your options under the Affordable Care Act. During this year of enrollment, you can select a new plan or renew a former plan. Whatever the choice, and whatever the exchange, HealthMarkets can help you sort through the options and find the one with the most value for you. Plus, we can provide help and guidance on plans, enrollment, subsidies, and more.


1. Kaiser Family Foundation. 2021. Retrieved from

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