Tuesday, October 1, 2019

For Some States, the Time is Right to Cut Ties with HealthCare.gov

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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