States Looking to Run Their Own Health Insurance Marketplace See Opportunity for Funding, Flexibility

By Rachel Schwab and JoAnn Volk

Last week, Pennsylvania Governor Tom Wolf signed legislation to establish a state-based health insurance marketplace. Under the Affordable Care Act (ACA), states are required to establish marketplaces to facilitate the sale of comprehensive health plans, either as a state-based marketplace or as a part of the federally facilitated marketplace. While the law anticipated that states would largely opt to run their own marketplaces, the majority of states chose the federal marketplace and the federal eligibility and enrollment platform, HealthCare.gov. Recently, along with Pennsylvania, several states have taken steps towards transitioning to their own marketplace and enrollment website.

In their newest post for the Commonwealth Fund’s To the Point blog, CHIR’s Rachel Schwab and JoAnn Volk review the latest state actions to transition to a state-run platform and break down some of the incentives for states to leave the federal marketplace. In addition the ability to counter federal policies that have reduced resources for the federally facilitated marketplace, state-based marketplaces give states the opportunity to capture user fees, achieve greater autonomy, and customize their enrollment platforms. You can read more about current state efforts to transition away from HealthCare.gov and motivations for doing so here.

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