Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act (ACA), developed in collaboration with the National Academy of Social Insurance, is based on interviews with policy and technology leaders from the "early innovator" states that are developing HIX IT models that can be adopted and tailored by other states. Executives at other state exchanges that have made significant progress in designing and developing exchanges, and others that are modernizing Medicaid and CHIP eligibility systems, were also interviewed.