Under the federal law, health care exchanges aren't required until next year, but some states have rejected moves to get started now. The exchanges are intended to keep costs low by pooling as many uninsured people together as possible.
Vincent DeMarco of the Maryland Citizens Health Initiative says so many questions remain on implementing these new exchanges that it's good to get started early.
"The people in Maryland are going to be much better off than the people in these other states that are not doing it right, that are resisting it," he says. "The best thing officials can do is what Governor O'Malley and Lieutenant Governor Brown are doing, which is move right now to figure out the best way to fully implement the Affordable Care Act."
The General Assembly did add a caveat to the bill though: It is requiring the health exchange board of trustees to come back to the assembly for approval of its recommendations. Lawmakers say that gives them more flexibility and retains their final say of how the exchange is implemented.