So, how are those sate run health insurance exchanges really working?

After spending 248 million dollars, Oregon has pulled the plug on Cover Oregon (its state run health exchange) and is switching to the federal system. Oregon was not able to enroll one person successfully on its exchange after its rollout in 2013.

Maryland, after spending over 100 million dollars on its health insurance exchange, has experienced massive difficulties and problems and is rebuilding its exchange.  If the rebuilding project appears to be struggling, federal officials could withhold funding and pressure Maryland to switch to the federal system—just like Oregon.

The much heralded Massachusetts RomneyCare health exchange, which broke open the exchange model, is dropping central parts of its exchange and joining the federal system with governor Deval Patrick requesting another 50 million dollars in funding in March to continue operating the Massachusetts exchange after previously winning 180 million dollars in grants.

Meanwhile, the future of Nevada Health Link is up in the air.  The special enrollment period ends on May 30, and customers are still reporting problems. Nevada is debating whether it should fix the current system, purchase another state’s system or follow Oregon’s lead and pull the plug on Health Link and move over to the federal system.  Nevada is currently checking to see if any federal funding is available to help with its three options.  The state board is expected to meet on May 20th and could make a decision then.

Only months before rolling out Vermont Health Connect, the state of Vermont changed from software developer Oracle to a subsidiary of CGI.  The resulting system is slow with no way for users to correct mistakes or to process premium payments.  The 171 million dollars in federal money set aside for implementing the state exchange will go away at the end of the year, and, “if Vermont Health Connect isn’t completely functional by then, the state could be on the hook for millions of dollars in unanticipated costs.”  Not good news for the Green Mountain State and Senator Jeanne Shaheen, a big ObamaCare backer.

In addition to that, Washington D.C.’s exchange, DC Health Link, will fund its 28.8 million dollar exchange in 2015 by taxing all health insurance providers in the Washington DC area.  This includes carriers not offering health insurance on the exchange.  Who do you think will get to pay those additional taxes?  The obvious answer is health insurance policy holders.

Cary Hall

America’s Healthcare Advocate