What's the state's role in enacting reform in the longer term?

After guarantee issue and the prohibition of pre-existing condition exclusions take force in 2014, the state is required to establish a nonprofit reinsurance entity to help cover the costs of high-risk individuals to be in place until 2016. This is to prevent rate shock.

States will also be required set up Exchanges in 2014 that provide coverage options to individuals and small businesses.

Exchanges have been likened to "Orbitz for health insurance" as they are meant to be an online market place with a variety of health insurance options for individuals and small businesses. 

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