States Looking to Run Their Own Health Insurance Marketplace See Opportunity for Funding, Flexibility

The Affordable Care Act (ACA) brought about landmark reforms, including the requirement for states to establish insurance marketplaces to facilitate the sale of comprehensive health plans. The law anticipated that states would largely elect to run their own marketplaces, but offered a federal fallback option. After evaluating the state-based marketplace model, and the variants allowing states to have partial control over their marketplace, most states opted for the federal marketplace. But recently, some have expressed interest in transitioning away from the federal model.