Seven states have cleared a federal milestone that enables them to run a state-based exchange.
But their status is tied to their ability to meet federal guidelines and implement their own plans.
Health and Human Services Secretary Kathleen Sebelius made the announcement Thursday.
SEBELIUS: "This process has been guided by our belief that states know their own needs better than anyone else.
That's why we've worked so hard to give states the flexibility and resources to create and participate in marketplaces that work best for their citizens."
A total of nineteen states and the District of Columbia have been certified so far to partially or fully run the health insurance marketplaces.
Other states have until February 15th to apply to run an exchange in partnership with the federal government.
Nevada was also conditionally-approved to run a state-based exchange Thursday.