California and Vermont are the only states set to require medical insurers to bid for the chance to sell coverage through new exchanges being set up this year under the Obama administration’s health-care overhaul.

The 2010 Affordable Care Act gives states the power to impose a bidding system for insurers to join the exchanges as an option to help drive down costs. A survey of the 16 states that will run their own systems starting in October found that 12 won’t require such a system and at least one other is undecided.

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