Obamacare's National Exchange

The Health Insurance Exchange under Obamacare is not 50 "state" exchanges and one federal exchange to be imposed on recalcitrant states. Instead, this is a National Exchange with 50 State portals (websites) and one Federal portal into the National Exchange. All exchanges (portals) must comply with the Obamacare law and regulations. The first set of regulations uses the word "require" 811 times. The National Exchange is an IT infrastructure that includes data sharing with at least five federal agencies, money transfers (subsidies/premiums), and federal monitoring, enforcement and regulatory controls. A National Exchange was supported by President Obama and had been explicit in the U.S. House's version of the legislation. 

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