When the Affordable Care Act was signed into law by President Obama in 2010, the plan was for states to set up their own insurance marketplaces that would offer an easy way for non-seniors without employer-sponsored health insurance to buy health plans, most of which would be subsidized by the federal government based on income.

But two and a half years after implementation, only 13 state-run exchanges exist. Most state exchanges are run by the federal government, while some are federal/state hybrids.

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