Dive Brief:
- Five years after implementation of the Affordable Care Act, almost half of the 17 state-run exchanges are struggling financially.
- Among the issues causing financial stress are high costs for technology and customer call centers and low enrollment numbers.
- Some of the options being considered to ease the financial burden include raising fees for insurers, cost-sharing with other states and asking lawmakers for monetary assistance. Some states are even considering turning their marketplaces over to the federal exchange.
Dive Insight:
Until the Supreme Court decides in June whether to take away the subsidies being offered to consumers in the 34 states that are using the federal exchange, the struggling state-run exchanges will likely continue to go it alone. If the court determines the subsidies should be upheld, some states will likely turn their marketplaces over to HealthCare.gov.
"Everyone is looking at all the options," Jim Wadleigh, executive director of Connecticut's exchange, which is considered one of the most successful of the state marketplaces, told The Washington Post. Although states are "trying to find ways to become self-sustaining," he added, it is still questionable whether or not they will succeed.