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State RegulationsNY specificDifficulty 1/5

Under the Affordable Care Act, which statement correctly describes how health insurance exchanges may be operated?

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Answer & full 3-part explanation (select an option above, or peek)

Why D is correct

Under the Affordable Care Act, each state was given the choice to establish and run its own health insurance exchange. Where a state declined to act, the federal government stepped in and operates a federally facilitated exchange for that state's residents. This state-or-federal structure is why exchanges differ from state to state in name, operation, and oversight.

Why the other options are wrong

  • A) State-run exchanges exist; federal operation is only the fallback when a state does not act.
  • B) States have real operating authority under the act, not merely an advisory role.
  • C) Private insurers sell their products on exchanges but do not own or operate the exchanges themselves.

Memory hook

Your exchange, your choice: state-run, or the feds run it for you.

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