Some State Health Exchanges Could Move to Federal Exchange
State-run health exchanges are facing high costs and low enrollment, which could spur more of them to turn over control to the federal government, the AP/San Diego Union-Tribune reports.
Experts estimate that about half of the states that run their own health exchanges face financial struggles.
The federal government provided about $5 billion toward startup grants for state exchanges with the hope that state exchanges eventually would be able to sustain themselves. However, most of that federal funding already has been spent.
Three states -- Hawaii, Nevada and Oregon -- already have turned over their operations to the federal government. Hawaii was granted $205 million in federal startup grants and spent nearly $139 million. However, the state enrolled just 8,200 individuals in 2015 and will turn over enrollment in 2016 to HealthCare.gov.
Still, the Obama administration is seeking to keep state exchanges running. The administration's annual meeting with state exchange directors scheduled for the end of this month will focus on making state health exchanges sustainable.
Benefits of Moving to Federal Exchange
According to the AP/ Union-Tribune, the recent Supreme Court ruling upholding the subsidies to help U.S. residents purchase coverage through the federal exchange means that there now is no disadvantage to states having the federal government run their exchanges.
Meanwhile, deferring to the federal exchange could allow states to combine functions and resources to maintain control over:
- Consumer education;
- Health plan oversight; and
- Marketing.
Peter Lee, executive director of California's health exchange, said now that states are less pressured to uphold health insurance expansion, "I think you are going to see much more of a hybrid across the nation." Lee said states are "talking a lot about shared services," adding, "It's how you get economies of scale" (Alonso-Zaldivar, AP/San Diego Union-Tribune, 7/26).
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