The main goal of the Exchange is to achieve a robust and stable enrollment and reduce the number of uninsured persons in the state. It may use alternative contracting options and active purchasing strategies to increase affordability and quality of care for consumers and lower costs in the health care system overall. As of 2016 the Exchange may use alternative contracting strategies such as competitive bidding. In creating the Exchange, the Exchange shall be in compliance with the ACA, consider reccomendations from stakeholders, may not impose penalties for enrollement termination, and must provide advance directives information sheets.