On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. It includes a number of significant changes to America’s health care system, including a requirement that every American have health care coverage or possibly face a tax penalty, and new taxes and penalties on employers that don’t provide employees with specific types of health coverage. The ACA also mandates the creation of health insurance marketplace exchanges in every state, through which individuals and small business owners can purchase health insurance.
The ACA allows three options to administer an exchange: states can run the exchange themselves, choose not to run it and leave it to the federal government, or leave it to the federal government while retaining the right to regulate health insurance and control eligibility decisions for their Medicaid programs. On November 16, 2012, Governor Kasich notified the U.S. Department of Health and Human Services that Ohio will not administer an exchange but will retain regulatory control over health insurance plans offered through a federally-operated exchange.
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