Is poised to become the only exchange?

It's possible that will become the only exchange in the country--more than half of the states use the federal exchange while others are likely to opt in soon, reported Politico.

Although the federal option was supposed to be a temporary fallback for a state that couldn't build its own marketplace, states that chose to rely on aren't interested in starting their own exchanges.

In fact, a few states have switched from their broken marketplaces to the federal version. After Oregon's exchange was plagued with technical problems preventing consumers from enrolling in one sitting, Oregon officials opted to shift to, FierceHealthPayer previously reported.

The problem, however, is the U.S. Department of Health & Human Services lacks appropriate funding and preparation to continue operating "We're kind of, in a way, stumbling into this situation" without any public discourse, says Tevi Troy, a health expert who served in the George W. Bush administration.

Some state officials say the federal government should operate the exchanges. Kansas Insurance Commissioner Sandy Praeger thinks the federal marketplace should allow states more flexibility and essentially evolve into "a comfortable fit rather than an imposed upon, top-down requirement."

If Praeger's scenario comes to fruition, there would be "little reason for states to take on the IT challenge" of running their own exchange, Jon Gruber, an economist at the Massachusetts Institute of Technology, told Politico.

And some states, like California, have achieved success on their own. Covered California had enrolled almost 830,000, and 80 percent of those consumers already paid their first month's premium. It's unlikely that states like California and New York will be switching to the federal exchange any time soon.

To learn more:
- read the Politico article