When it comes to health care, there are few magic-bullet solutions for the many problems consumers face in the marketplace: insurers don’t compete for their business, leading to higher prices and lower quality. Important information about coverage is buried in the fine print, making it hard to know what’s really covered or which plan is right. And costs are continuing their unsustainable rise. Yet there are policy solutions that can make a difference and give consumers a better deal on health care. One of the most important of these is the creation of new state-based health insurance marketplaces, called exchanges. These exchanges, authorized by 2010’s health reform law, offer the states the chance to address the twin problems of cost and quality, and help consumers get a fair shake when buying insurance.