With the the Patient Protection and Affordable Care Act (PPACA) upheld by the U.S. Supreme Court, half of the states in the nation now face a federally run health care exchange, the default for states that haven’t made progress or declined involvement in setting up a state run marketplace for health insurance coverage.
See also: State-Based Exchange Status Map
“I think there is going to be a lot more interest now in what the states are doing,” said Sandy Praeger, Kansas insurance commissioner and head of the NAIC’s Health Insurance (B) Committee.
In Kansas, Gov. Sam Brownback has sent back $31 million of early innovator planning grant funds for the Exchange, and has said he wants to wait until after the election to make a decision on a state exchange. There was no legislative support for a state-based exchange, anyway, Praeger noted.
KPMG was hired by the Pennsylvania Insurance Department as part of the Commonwealth’s ongoing analysis of options to be considered in determining the Commonwealth’s plans to comply with the health insurance exchange requirements of PPACA.
Of significant concern to states is the self-funding — at the end of the day, will taxpayers directly or indirectly have to pay for the exchange? That is what the state will be exploring with the grant money to determine what decision it would make in terms of pursuing a state-based exchange, Consedine said.