There are three potential options that states can choose from for their health insurance exchanges. Some states have selected to create a state-based exchange. Another option is a federal and state partnership. Others have decided to allow the federal government to create an exchange for their state. Here are some more of the states that will have federal exchanges.
Missouri
On November 6, 2012 (the same day as the 2012 Presidential election), Missouri voters passed a ballot measure blocking Governor Jay Nixon from establishing an exchange via Executive Order. The Governor initially supported running a state-based exchange, but he announced that Missouri would default to a federal exchange. The federal government will assume full responsibility for running a health insurance exchange in Missouri beginning in 2014.
Nebraska
Earlier on 2012, the Nebraska legislature introduced two bills to establish a health insurance exchange in Nebraska. Both failed when the legislative session ended in April of 2012. On November 15, 2012, Governor Dave Heineman announced that Nebraska would not establish a health insurance exchange. The federal government will assume full responsibility for running a health insurance exchange in Nebraska beginning in 2014.
North Dakota
In 2011, North Dakota explored the possibility of a state-based exchange. Planning efforts halted after a second 2011 bill to established a state-based exchange failed. In November of 2012, Governor Jack Dalrymple announced that North Dakota was not planning a state-based exchange. The federal government will assume full responsibility for running a health insurance exchange in North Dakota beginning in 2014.
South Carolina
Governor Nikki Haley created the South Carolina Health Planning Committee via Executive Order to assist with the policy recommendations regarding if (and how) South Carolina should establish a health insurance exchange. Her influence over the Committee’s findings was called into question in December of 2011. On November 15, 2012, Governor Haley informed federal officials that South Carolina would default to a federally-operated health insurance exchange. The federal government will assume full responsibility for running a health insurance exchange in South Carolina in 2014.
South Dakota
On September 26, 2012, Governor Dennis Daugaard announced that South Dakota would not establish a state-based health insurance exchange. The federal government will assume full responsibility for running a health insurance exchange for South Dakota in 2014.
Texas
On July 9, 2012, Governor Rick Perry announced that Texas would not establish a state-based health insurance exchange. The federal government will assume full responsibility for running a health insurance exchange for Texas in 2014.
Wyoming
On November 14, 2012, Governor Matt Mead announced that Wyoming would default to a federally-operated health insurance exchange for 2014. There is possibility that Wyoming will move to a state-based exchange in the future. As it stands, the federal government will assume full responsibility for running a health insurance exchange in Wyoming starting in 2014.
Image by Marc Falardeau on Flickr