“We have no interest in spending our tax dollars on an exchange that is state-based in name only,” the governor said. “I would support a free market-based approach that could serve as a useful tool for Georgia’s small businesses, but federal guidelines forbid that. Instead, restrictions on what the exchanges can and can’t offer render meaningless the suggestion that Georgia could tailor an exchange that best fits the unique needs of its population."
In light of this decision, the federal government will create and manage a health insurance exchange on the state's behalf. By 2014, both state residents and small businesses will be able to search the federal exchange for health plans that offer a package of basic medical services.