The federal government will be running new health insurance marketplaces, also known as exchanges, in at least 26 states, says an article by Kaiser Health News. These states include the major population centers of Texas, Florida, and Pennsylvania.

The Obama administration has given "conditional approval" to 17 states and the District of Columbia to run their own marketplaces. About 12 million people are expected to buy coverage through the Internet sites next year, with the number increasing to 29 million by 2021, according to consulting firm PriceWaterHouseCoopers.

For consumers, it should make little difference whether the new Internet sites are run from state capitals or Washington, DC. But federal regulators hoped states would shoulder some of the work and that stakeholder groups such as hospitals and insurers wanted states to help, too. The exchanges become effective October 1. 

Governors from Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, and West Virginia have sought approval for the third option— a partnership with the federal government. Three of those states—Arkansas, Delaware, and Illinois—have received conditional approval, says the article. 

In a partnership, states would approve which plans can participate on the marketplace and handle consumer assistance duties, such as setting up call centers to handle inquiries. The federal government would handle the more complex duties of running the website, marketing the site, and determining the eligibility of millions of people for government subsidies that will make prices more affordable.