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Feds to Run Health Insurance Exchanges in Half the States

To date, 23 states and Washington, D.C., have opted to run their own insurance exchanges or partner with the Obama administration to do so, while 26 states are defaulting to the federal government...
February 21, 2013

To date, 23 states and Washington, D.C., have opted to run their own insurance exchanges or partner with the Obama administration to do so, while 26 states are defaulting to the federal government. Friday, February 15, was the deadline for states to decide.

The Obama administration has given “conditional approval” to 17 states and the District of Columbia to run their own exchanges. Twenty-five states, most Republican-led, have said they will let the federal government run the marketplaces, also known as exchanges. And seven governors from Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire and South Dakota have sought approval for the third option — a partnership with the federal government. Three of them — Arkansas, Delaware and Illinois — have already received conditional approval. West Virginia also decided late Friday to opt for a partnership with the federal government.

“It’s healthy for the states to have various choices,” says Ben Nelson, CEO of the National Association of Insurance Commissioners (NAIC). “And there’s no barrier to taking somebody else's ideas and making them work in your situation.” Kansas Insurance Commissioner Sandy Praeger observes, “There is a sense of irony that it’s the more conservative states” submitting to federal control.”

States doing their own online exchange:

California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Utah, Vermont and Washington

States doing a partnership with the federal government:

Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, South Dakota and West Virginia

States defaulting to the federal exchange:

Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin and Wyoming

Details on the status of all 50 states’ health exchanges can be found on this interactive map published by the Kaiser Family Foundation.

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