During the initial stages of the open enrollment period under the Affordable Care Act, many state-based exchanges realized that their preparations for the health care overhaul were insufficient, evidenced by many people having their policies canceled and not being able to purchase coverage through HealthCare.gov or through alternative means. As a result, some state-based marketplaces said that they would overhaul the system and start fresh.
Few appear to be making headway, however.
According to recent analysis from independent research organization The Commonwealth Fund, all-new, state-based marketplaces are unlikely to be in place by 2015. Only a handful of states – namely Arkansas, Illinois, Iowa and Mississippi – are "taking active steps" toward that realization.
"So far, only Arkansas has enacted legislation allowing for a transition to a state-based marketplace," the report stated. "The governor of Illinois has continued to advocate for passage of establishment legislation, while Iowa has proposed establishment legislation and recently received a grant to transition to a state-based marketplace."
Meanwhile, six states are going to work on optimizing their technological glitches that consumers who don't already have employee benefits have experienced trying to enroll through the exchanges. These include Hawaii, Maryland, Massachusetts, Minnesota, Nevada and Oregon, the report specified
"Health insurance marketplace implementation to date has led to a far more varied landscape than was outlined by the [ACA]," said The Commonwealth Fund's Sarah Dash and Amy Thomas, co-authors of the study. "The next few years of implementation may be similarly dynamic, although with establishment legislation having passed in only one state and with governors required to sign the state declaration letters due May 1, it is unlikely that any new state-based marketplaces will be created in 2015."
Sign-ups in the exchanges have been somewhat underwhelming in several parts of the country, based on numbers compiled by the Kaiser Family Foundation. Less than 12,000 people have selected plans in Wyoming and 10,600 in North Dakota.
