Smaller States Debate the Benefit of Running Their Own Health Exchanges

Facing high costs but smaller budgets, some states are struggling to find financially and politically sustainable ways to keep their health exchanges running.

The size of smaller states' markets are small—meaning there’s less revenue from taxes—but they face many of the same fixed costs in maintenance and technology as large states do. Also like their larger counterparts, states like Hawaii, Rhode Island and Vermont plus the District of Columbia can no longer depend on the federal grants they used to initially develop and fund their exchanges. The federal Centers for Medicare & Medicaid Services (CMS) prohibited using those grants toward operations starting earlier this year.

In statehouses over the next several months, debates will rage over how to fund exchanges -- but also whether those exchanges are worth maintaining at all, and in what form.

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Source: Governing