States consider combining exchanges amid growing financial concerns

A multi-state health insurance exchange may be the wave of the future as the debate continues regarding how states will fund their health insurance exchanges once federal funding stops next year, the Hill reported.

States also are mulling this idea should the Supreme Court's decision in King v. Burwell next month strike down federal subsidies in states that don't operate their own marketplaces.

The multi-state exchange option, hidden in the Affordable Care Act, interests states hoping to reign in some of the costs associated with establishing state-run exchanges.

Connecticut--which operates one of the most successful exchanges in the country--already has received requests from a handful of states hoping to form a contingency plan should they need to scramble and establish their own marketplaces, Jim Wadleigh, the director of Connecticut's exchange, told the Hill.

While Wadleigh declined to say which states he had conversed with--mostly due to the political backlash should the names get out--he did state, "Clearly, we can't sell the code, which was paid for by federal dollars, but what we can do is have collaborations like joining exchanges, if that's feasible."

Creating a multi-state exchange won't be a walk in the park. It would be difficult for states to manage risk pools, for instance, the Hill pointed out. This obstacle has prevented some states from moving forward with the plan.  

However, what may work is for states to share their technology systems, with all participating states hiring the same contractor.

The option to merge state-run exchanges will remain on the table as long as single-state exchanges struggle to pay the bills. Hawaii recently announced that it will shut down its marketplace as of Sept. 30 due to financial instability, FierceHealthPayer previously reported.  

For more:
- here's the Hill article