The public health insurance exchange put in place by the Affordable Care Act has not transformed the U.S. health care system in the way that some hoped or feared.

Few employers have not used the existence of the individual exchange as an excuse to scrap their health care plans.

However, many hope that the concept of health care exchanges, in both the public and private sectors, will become a mainstay of the U.S. health care system, forcing consumers to take more responsibility for their coverage.

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