26 states defer to federally-run exchange

With Friday's deadline passed for states to decide whether they will run their own health insurance exchange, it's now official that the federal government will be operating marketplaces in 26 states.

That's a lofty task the U.S. Department of Health & Human Services must undertake, particularly because exchanges are based on systems that typically take two or three years to build. But HHS has less than eight months to accomplish this logistical challenge before open enrollment begins in October, reported The Washington Post's Wonkblog.

And it might not be great news for insurers, who favored state-run exchanges because they have more influence with state regulators, Kaiser Health News reported.

Although Massachusetts Institute of Technology economics professor Jonathan Gruber has been advising states to default to the federal-run marketplace, he thinks more states will take control over the long-term. "As the law becomes more accepted, I see states taking a larger and larger role" in future years, Gruber told MedPage Today.

States wanting to run their own exchanges are: California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont and Washington, according to an Avalere report.

States that have applied for a partnership model with HHS include Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire and West Virginia.

And HHS will operate the marketplaces in Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Wisconsin and Wyoming. 

To learn more:
- here's the Avalere report (.pdf)
- read the Washington Post's Wonkblog article
- see the Kaiser Health News article
- check out the MedPage Today article

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