Friday was the deadline for states to announce whether they will partner with the federal government to create a benefits exchange, but many states still face a series of decisions concerning the Affordable Care Act mandate.
The governments that chose to hand the reigns over to Washington will have to decide whether they will be involved in controlling rates and regulating who can participate in state plans, according to USA Today.
“The states will be saying, ‘We’ve always done this and we want to continue,’ ” Joel Ario, managing director at Manatt Health Solutions and former director of health insurance exchanges, told the newspaper. “These are the details to still work out.”
In the past, state commissioners have overseen insurance provider participation and rates.
Federally-run exchanges may have a more difficult time maintaining stable insurance markets than systems that run in full or in part by states, claimed Sarah Goodell in a recent policy brief for Health Affairs and the Robert Wood Johnson Foundation.
The U.S. Department of Health and Human Services originally assumed more states would create and run their own exchanges or do so in partnership with the federal government. However, 25 states have chosen to let Washington control their systems completely, which means federal health leaders will likely face many particularities when working with each state.