A major decision is expected any day that will determine how the state will implement a key part of the Affordable Care Act. By Friday, Ohio must announce whether it will set up a state-run health insurance exchange, or let the federal government operate it. An exchange is a place where consumers and small businesses can compare and shop for private health insurance.

President of the Health Policy Institute of Ohio, Amy Rohling McGee, says the state could also choose a "hybrid" model and maintain some control of the exchange.

McGee says that approach would also allow the State to possibly set up a state-run exchange in the future.

Governor John Kasich hasn’t announced a decision, but it’s unlikely a state-run exchange is in the cards. No matter who runs it, Ohioans should be able to purchase insurance directly from the exchange in 2014.

President Obama recently announced that while states must still say by November 16th whether they plan to build their own marketplace, they can now wait until December 14th to submit their plans. An estimated 12 million people are expected to get insurance through the exchanges.