States stick to insurance exchange models

From Crain's Business News, May 20, 2014 (excerpts)

...For the 2014 enrollment period, 26 states and the District of Columbia opted to run their own marketplaces, while 17 states relied completely on HealthCare.gov, and the remaining seven resorted to partnerships intended as bridges to independent exchanges. States had until May 1 to declare if they wanted to switch models, and the CMS received none, an agency spokeswoman said.

The lack of response is surprising given that several states, particularly Hawaii, Maryland, Massachusetts and Oregon, were widely expected to ditch their own exchanges after severe technical problems impeded many consumers from signing up for coverage online. Meanwhile, many expected Iowa and Illinois to end their partnership arrangements and take full control of their exchanges.

Late last month, the board of Oregon's troubled exchange voted to jettison the state's site, and use HealthCare.gov to enroll beneficiaries into plans. Despite the switch, the state has retained enough day-to-day oversight in managing its qualified health plans that the CMS still considers Oregon to have a state-based exchange, a spokeswoman for Cover Oregon said....

The CMS says it will continue to be flexible with states that decide they need to turn to HealthCare.gov for the 2015 enrollment period.

Massachusetts is working on a dual track, attempting to rebuild its state exchange with a new vendor while also working on a plan that involves ceding control of its marketplace to the federal government. State and federal said they hope the course will be clear by July.

“These are state decisions, we aren't forcing them to choose one path or the other, and are instead working with them on what makes the most sense for their state and for their consumers,” a CMS spokeswoman said. “We are working with Massachusetts on a timeline based on their decisions.”....

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Background: Congressional Delegation Blocks Obamacare Exemption to Avoid “Awkward Political Narrative”