Baltimore's Inner Harbor. (AP Photo/Chris Gardner)

Maryland Gov. Martin O’Malley, D, is getting ready to sign H.B. 443, the Health Benefit Exchange Act of 2012.

The Patient Protection and Affordable Care Act of 2010 (PPACA) is supposed to create a system of Web-based health insurance distribution supermarkets for individuals and small groups. States can choose to run their own exchanges, participate in multi-state exchanges, or get exchange services from the federal government.

If PPACA takes effect as written and works as drafters and implementing agencies expect, a state will be able to choose whether to open an exchange to all carriers that meet basic quality standards or play an active role in bargaining with carriers for richer benefits packages and lower prices.

The Maryland House voted 94-44 for the bill, and the Maryland Senate voted 36-10 for the bill.

O’Malley has not yet scheduled a signing date but plans to sign the bill into law shortly, a representative says.

Maryland already has received about $34 million in federal exchange construction grants.

The new exchange act will allow the exchange to use active purchasing strategies, or bargaining efforts, to try to reduce exchange plan costs and increase exchange plan quality after the first two years that the exchange system is in operation, officials say.

The Maryland bill would require exchange “Navigators,” or ombudsmen, to refer consumers to agents and brokers for information about products not available through the exchange; require Navigators to be licensed; require the small business exchange to work with health insurance agents and brokers; and allow employers using exchanges to choose the dental and vision plans that will be offered to their employees.