A new survey conducted by the KPMG Government Institute, an analysis organization that focuses on government policy and legislative trends, provides some insight on some of the challenges facing states in their efforts to build a health insurance exchange. The survey draws upon information provided by 80 state officials from throughout the country. These officials offered information on why health insurance exchanges seem to be such a troublesome issue. The common consensus boils down to cost. The survey suggests that insurance exchanges may be too expensive for some states, even with the help of the federal government.
According to the survey, 31% of states consider cost their primary challenge to building a health insurance exchange. One in five state officials note that political issues are compounding the matter as state legislators have had trouble agreeing on plans – financial or otherwise – concerning exchanges. Another 11% of state officials cited the uncertain future of the Affordable Care Act as the reason they have backed away from complying with the health care law.
The financial concerns of states are persistent despite federal grants awarded to states to help mitigate the costs of building an insurance exchange. KPMG notes that these challenges may mean that some states will not be able to build their own exchange. In these cases, the federal government will build an exchange for them, but state officials will not be able to govern the program.