Dive Brief:
- State health insurance marketplaces are struggling with high costs and low enrollment numbers.
- Many may decide to turn over their operations to the federal government or share resources with other states.
- Hawaii is planning to turn its operations over to the federal government next year. Nevada and Oregon switched over last year.
Dive Insight:
As of now, 12 states and the District of Columbia still run their own exchanges. According to industry experts, about half are facing financial difficulties.
"The viability of state health insurance exchanges has been a challenge across the country, particularly in small states, due to insufficient numbers of uninsured residents," the office of Hawaii Democratic Gov. David Ige said in a statement last month, announcing that his state's exchange was being turned over to the federal government.
Now that the Supreme Court has made its decision to allow customers in all 50 states to keep their insurance premium subsidies, there's really no downside for states to switch over to federally run exchanges.
Peter Lee, who heads California's state-run marketplace, told The Baltimore Sun that now that the pressure is off, he thinks the industry will see "more of a hybrid across the nation." Lee said there have been discussions among states about shared services. "It's how you get economies of scale," he said.