We're less than three months away from the start of open enrollment for the health insurance exchanges created by the Affordable Care Act, and Marilyn Tavenner is busily trying to spread the word. Tavenner manages the Centers for Medicare & Medicaid Services, the $820 billion federal agency charged with implementing the rollout of the exchanges. The state-based exchanges will enable individuals and small businesses to shop for health plans. The exchanges, or marketplaces, will help consumers and small businesses to compare and purchase qualified health plans. The exchanges of 26 states, including Texas, will be operated by the federal government.