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Throughout the U.S., progress on setting up health insurance exchanges is accelerating. As of December, 2011, 13 states had fully functional exchange programs. Several other states have legislations pending that would allow for the building of the exchanges. While many states oppose the overarching Affordable Care Act, only Arkansas and Louisiana have chosen not to build insurance exchanges of any kind. According to the law, all states must have an operational exchange program in place by 2014.

As of now, 20 states are making major progress toward establishing exchanges. The remaining 28 – minus Arkansas and Louisiana – have been making much slower progress. These states have voiced concern over continuing efforts to build exchanges in light of the fact that the Affordable Care Act is on its way to the Supreme Court. The Court is expected to rule on the constitutionality of the law. If deemed unconstitutional, the law will be dissolved and states will no longer be required to build exchanges. Given the fact that these programs cost a great deal of money, states may be inclined to discontinue work on exchanges, which may make insurance unattainable for those that need it most.

The nation’s insurance industry has been torn on the issue of insurance exchanges. Some insurers have shown favor for the programs as they would allow them to reach more consumers. Consumer advocacy groups and insurance analysts claim that exchanges would bring more competition to the industry, which would lower prices nationwide.

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