The Obama administration said that 19 states got federal approval to start their new healthcare exchanges, that was created under the Affordable Care Act. States such as Califronia, Hawaii, idaho, Nevada, New Mexico, Vermont and Utah all got approved to operate their healthcare exchanges. The Obamacare law does not make it mandatory for a state to create a health insurance exchange, but it does hold that if an individual state does not create their own exchange or partner with the Federal government to create a health insurance that the federal government will create one for them.