By Leslie Small
In the early days of the
Affordable Care Act, some states struggled to get their homegrown health
insurance exchanges off the ground and thus opted to rely on the federal
HealthCare.gov platform. Now one of those states — Nevada — is taking a second
stab at setting up an exchange independent of the federal government.
According to Silver State
Health Insurance Exchange Executive Director Heather Korbulic, while
HealthCare.gov once charged just 1.5% of gross individual market premiums that
the state collected for the right to use the federal enrollment platform, it
has since hiked the fee up 3%. "The 3% fee from CMS basically our entire
budget," she explains.
Another reason for the
state's transition is the "rigidity" of HealthCare.gov as it relates
to state flexibility, she says. "Many years of working with our HealthCare.gov
partners was fruitful, but it was also kind of painful in terms of having very
little insight into who our consumers are, where they are, and then also into
providing us any meaningful opportunity to make changes just specific to our
state."
Pennsylvania, New Jersey
and New Mexico are also transitioning to a state-based exchange, while Maine
and Oregon are considering doing so, according to a recent article from
Stateline.
Asked why states are once
again warming to the idea of running their own exchanges, Rosemarie Day,
founder and president of Day Health Strategies LLC, says that "the markets
are stabilizing in many places, and you're even seeing some insurers that had
pulled out decide to go back in, so that gets attention."
In addition, states have "observed
a disinvestment in HealthCare.gov from the federal government," Day says.
"The next factor I
would say is that in the original days of launching state-based exchanges, it
was a very expensive proposition, but at this point, the other thing that's
stabilized is the technology that's needed to actually make a state exchange
work," she says.
From Health Plan Weekly
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