Pursuant to the Patient Protection and Affordable Care Act, beginning in 2014 individuals and small businesses will have access to the purchase of private health insurance through insurance exchanges. States are required to set up health insurance exchange markets, both for small businesses (the Small Business Health Option Program, or SHOP) and for individuals, or a single exchange that combines both. Forty-nine states have applied for grants to help plan and operate exchanges.

On August 12, the United States Department of Health and Human Services released a proposed rule titled the ‘Exchange Eligibility and Employer Standards,’ which attempts to create uniform standards and systems for enrolling in insurance plans through the exchanges. The goal is to provide ‘competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors.’