In 2010, President Barack Obama signed into law the Affordable Care Act (ACA), which provides new health insurance options for uninsured Americans. The ACA requires each state to establish and operate a Health Benefit Exchange, unless the state elects to have the federal government operate its Exchange. The Health Benefit Exchanges will allow millions of people who do not have health insurance to apply and be screened for eligibility for public assistance programs, such as government health insurance subsidies and Medicaid.

The California Health Benefit Exchange was established under the ACA and is required to offer – through one streamlined application process – eligibility screening and enrollment in public assistance programs such as MediCal, as well as government health insurance subsidies to be offered for the first time under the ACA.

Section 7 of the NVRA, 42 U.S.C. section 1973gg-5 (a)(2)(A), requires that "each state shall designate as voter registration agencies… all offices in the state that provide public assistance" (emphasis added). Since the California Health Benefit Exchange is a new state agency providing access to and enrollment in public assistance programs, the NVRA requires the agency to be designated, pursuant to 42 U.S.C. section 1973gg-5(a)(2)(A), as an NVRA voter registration agency.

On May 15, 2013, Secretary of State Debra Bowen designated the California Health Benefit Exchange (Exchange) as an NVRA voter registration agency, pursuant to Section 7 of the NVRA, 42 U.S.C. section 1973gg-5 (a)(2)(A).

Copies of Secretary Bowen's letter to the Exchange and the official declaration designating the Exchange as an NVRA agency are below: