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This document outlines the continuum of exchange options available for health care coverage under state-based and federally-facilitated exchanges. State-based exchanges handle all exchange activities, including plan management and consumer assistance, while also determining eligibility for Medicaid and CHIP. In contrast, federally-facilitated exchanges, operated by the HHS, oversee all exchanges and similarly assess Medicaid/CHIP eligibility. This guide aims to clarify the roles and responsibilities of both exchange types in facilitating access to health care services.
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Continuum of Exchange Options State-based Exchange State operates all exchange activities State-Federal Partnership Exchange State operates plan management and/or consumer assistance activities; may determine Medicaid/CHIP eligibility Federally-Facilitated Exchange HHS operates all exchange activities; state may determine Medicaid/CHIP eligibility
