"Differences in the intensity of efforts across the states are stark. Those that have chosen to establish their own state-based marketplace have developed state-specific marketing campaigns showcasing unique themes and concerns of residents, and have also targeted substantial resources to support enrollment assistance networks.... While federally facilitated marketplaces may work just as well as their state-based counterparts, they may not be supported by the same level of marketing and enrollment assistance. These distinctions may contribute to noticeably different experiences in enrollment during the first year of ACA implementation, and perhaps longer term."

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