The role that insurance agents play in the health marketplace in 2014 and beyond will likely be left up to the states, said Joel Ario, head of the insurance exchange bureau of the federal Department of Health and Human Services (HHS).

Consistent with recent comments made by Kathleen Sebelius, HHS secretary, Mr. Ario said HHS prefers that states manage the exchanges and that the federal government will step in "only if there is no alternative."

Speaking at the annual Capitol Conference of the National Association of Health Underwriters (NAHU), Mr. Ario also promised that states will have flexibility in determining the role of agents in the "navigators" system—a component of the health care law that agents fear is designed to limit or eliminate their role in the health care system.

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