The deadline for states to decide on the route to take for their health insurance marketplace has come and gone without any last minute decisions. As NAHAM News reported last week, states had to decide by Friday whether they wanted to set up their Health Insurance Marketplace in partnership with the federal government, or if they wanted to take no action and allow the federal government to set up the marketplace without state input. According to Kaiser Health News, half the states— including the major population centers of Texas, Florida and Pennsylvania, opted to do nothing, and defaulted to the Federal option.
Alternatively, seventeen states and the District of Columbia have been given “conditional approval” by the Administration to set up their own marketplaces, without help from the federal Department of Health and Human Services (HHS). These states include California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont, and Washington.
An additional seven states have opted for a partnership exchange. Under this marketplace type, states would approve which insurance plans could participate in the marketplace, and handle consumer assistance duties such as setting up call centers to handle inquiries. The federal government would handle the more complex duties of running the website, marketing the site, and determining the eligibility of millions of people for government subsidies which will make prices more affordable. HHS and the Administration had hoped that sharing the responsibility through this type of marketplace would entice more states to take some form of an active role in the program. Partnership states include Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, and South Dakota.
The remaining twenty five states defaulted to a federally run marketplace, disappointing Administration officials who had hoped for more state involvement. The states that opted for a federal program cited concerns about cost, lack of autonomy, or political opposition to the healthcare law.
You can view state by state marketplace statuses on the Kaiser Family Foundation website here.