The Affordable Care Act requires nearly everyone to have health insurance by January 1, 2014.  The federal health law gives states the option of creating health insurance exchanges through which their residents can purchase coverage.  With a presidential election on the horizon and a November 16 deadline for states to declare their intention and readiness to build an exchange, the majority of states are expected to let the federal government take over by default.

Health Exchanges: A Snapshot

Source: Pew Charitable Trusts