More states are moving forward to implement health reform and the exchanges that play a major role in the law, the Department of Health and Human Services said Thursday.

HHS conditionally approved Iowa, Michigan, New Hampshire and West Virginia to operate state partnership exchanges, which will be ready for open enrollment in October 2013.

A partnership agreement is just one of three exchange options for states. Exchanges can be run by individual states, by the federal government or by a combination of the two under an arrangement—the state partnership exchange. The partnership model is an option provided to states that want to manage part of the exchange in 2014. HHS says it allows states to make key decisions and tailor the marketplace to local needs and market conditions.

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