2012 Progress Report: “In the nearly two years since President Obama signed the Affordable Care Act into law, all States have taken some action to implement health reform. For example, forty-four States are participating in the new premium rate review system where insurers must justify the rationale for any double-digit insurance premium increase. And 28 States and the District of Columbia are on their way toward establishing their own Affordable Insurance Exchange – an essential component of the law. Affordable Insurance Exchanges are one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs. Starting in 2014, they will offer to the public the same kinds of insurance choices members of Congress will have. Exchanges will select health plans qualified to offer coverage; facilitate consumer assistance, shopping and enrollment; and coordinate eligibility for the Exchange and potential premium assistance.”