"Although many states will be positioned to stand up a State-based Exchange (SBE) on January 1, 2014, which requires at least conditional certification from the Department of Health and Human Services (HHS) on January 1, 2013,” some states “will choose instead to rely on a Federally-facilitated Exchange or a Partnership Exchange wherein the state will assume some of the Exchange functions that would otherwise be performed by the Federally facilitated Exchange,” explains a new report from the National Academy of Social Insurance. The report, funded in part by the Robert Wood Johnson Foundation, “reviews how the core functions of an Exchange might be effectuated in the different Exchange models, and the implications for states selecting varying models as interim or permanent solutions.” States will have to consider “the degree of responsibility they want to assume, control they must cede to the federal government, and state fiscal implications with respect to the core functions of the Exchange – some of which implicate traditional state insurance and Medicaid responsibilities and others that represent entirely new functions for both the state and federal government streamlined access to affordable insurance coverage as mandated by the ACA.”