It's go time: states have only a few months to get their health insurance exchanges up and running.

• Author: Salazar, Martha
• Position: HEALTH CARE

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Sound familiar? Then you've shopped online and may already be a pro at comparing options and prices through the Internet. Most likely you've bought a book or an airline ticket, perhaps even a car, online. Coming soon will be the chance to buy health insurance through a website--courtesy of the Patient Protection and Affordable Care Act--where you can compare prices, benefits and coverage. Never shopped online or don't have Internet access? That's OK, you'll be able to call a toll-free line to talk with someone about your options. These new services are known as health insurance exchanges, and with a tight deadline required by federal law eight months remain to get them up and running it's "go time" for states and the federal government.

The Basics Like it or not, and plenty don't, federal law requires the Internet-based health insurance exchanges to be operational in every state, ready to conduct an "open enrollment period" by Oct. 1 for coverage that will be effective Jan. 1, 2014. The Congressional Budget Office estimates that 25 million people will participate in the exchanges by 2022. Along with offering health insurance options, exchanges also need to be able to let people know if they qualify for federal subsidies or programs such as Medicaid or the Children's Health Insurance Program. Subsidies to purchase coverage are available to individuals with incomes between 138 percent and 400 percent of federal poverty guidelines. Decisions, Decisions, Decisions

States may operate their own health insurance exchanges, partner with the federal government or let the federal government run them entirely. There are many functions to running an exchange, from building databases to answering consumers' questions. Whether to take on these tasks requires big decisions from the states, with deadlines guiding the way. The most significant deadline has come and gone. By last Dec. 14, states had to declare their intentions to run a state-based exchange. Eighteen states and the District of Columbia decided they were up for the challenge. Now they are faced with more decisions, including choosing which carriers will participate, how the exchange will work with Medicaid and other public programs, and how it will be funded after federal money dedicated to the exchanges is no longer available in 2016.

States that chose not to create their own exchanges have just a few days--until Feb. 15--to decide whether to partner with the federal government to run them. As of Jan. 1, seven states had elected this option and will be...