Starting in 2014, HIEs will allow people to compare health insurance online on the basis of price, coverage and other options. People will also be able to use insurance exchanges to submit questions to insurers and find out if they're eligible for tax credits for private insurance programs, such as the Children's Health Insurance Program (CHIP).

To date, 49 states, the District of Columbia and four territories have accepted federal grants to set up insurance exchanges.

States can choose to develop a health insurance exchange in partnership with the federal government or develop the systems themselves.

"Exchanges offer Americans competition, choice, and clout," HHS Secretary Kathleen Sebelius said in a statement. "Insurance companies will compete for business on a transparent, level playing field, driving down costs; and exchanges will give individuals and small businesses the same purchasing power as big businesses and a choice of plans to fit their needs."

HHS's new draft rules offer states guidance and options on how to structure affordable insurance exchanges in two key areas: Setting standards for establishing exchanges, and ensuring insurance premium stability for plans and enrollees in the exchange.