3 ms·

So basically, (at least some) states that created their own exchanges made a big mistake in doing so.

TrainedMonkey 12y ago
I do not see how, given that the money they used were federal. While in terms of entire country that is certainly suboptimal, it is hard to imagine how on a state level getting a grant and using it to generate local business could be bad.
bluthru 12y ago
Why was it ever an option for states to create their own sites? Why bother with redundancy?
- jbooth 12y ago
  Local-perspective decision-making and "50 laboratories" are usually the general line for that kind of thing, with efficiency and consistency being the arguments in favor of federal control. Funnily enough, the states with Republican governors which usually push the local line didn't build their own exchanges, while the states with Democratic governors who are usually friendlier to federal control tended to build one. Politics.
- untog 12y ago
  To get the legislation passed, basically. It was a nod to states rights issues.
- jjoonathan 12y ago
  1. Because federalism and states-rights are considered by many Americans to be an important check/balance and 2. because the redundant work created by "upholding that philosophy" is an exploitable opportunity for those in power. #1 = political capital #2 = $$$ What's not to love (if you're a politician)?
- dragonwriter 12y ago
  > Why was it ever an option for states to create their own sites? Because the plans (as necessary because while the feds set some national standards, they have not displaced the states role as insurance regulators) are state-specific, and the exchange is supposed to provide gateways to both the state-specific insurance plans and the state-specific (and state-operated) Medicaid plans, and because it can also serve additional, related, state-specific functions. The option to fallback to a federally-facilitate marketplace (which, even if it is a shared website for many states, is still state specific) was originally envisioned as the least preferred option for a state exchange.
jobu 12y ago
Some failed and some did well. Connecticut did such a good job that other states (Maryland) are buying it. http://www.npr.org/blogs/health/2014/02/27/283526215/connecticut-looks-to-sell-its-obamacare-exchange-to-other-states http://www.npr.org/blogs/health/2014/02/27/283526215/connect...
SEJeff 12y ago
Kentucky created their own exchange and have been the poster child for ACA success as a result. It is super ironic given how anti-democratic / anti-obama the state is (I'm from KY, but live in Chicago): http://www.thedailybeast.com/articles/2013/10/17/obamacare-is-winning-in-kentucky-thanks-to-steve-beshear.html http://www.thedailybeast.com/articles/2013/10/17/obamacare-i...

I do not see how, given that the money they used were federal. While in terms of entire country that is certainly suboptimal, it is hard to imagine how on a state level getting a grant and using it to generate local business could be bad.

bluthru 12y ago

Why was it ever an option for states to create their own sites? Why bother with redundancy?

jbooth 12y ago
Local-perspective decision-making and "50 laboratories" are usually the general line for that kind of thing, with efficiency and consistency being the arguments in favor of federal control. Funnily enough, the states with Republican governors which usually push the local line didn't build their own exchanges, while the states with Democratic governors who are usually friendlier to federal control tended to build one. Politics.
untog 12y ago
To get the legislation passed, basically. It was a nod to states rights issues.
jjoonathan 12y ago
1. Because federalism and states-rights are considered by many Americans to be an important check/balance and 2. because the redundant work created by "upholding that philosophy" is an exploitable opportunity for those in power. #1 = political capital #2 = $$$ What's not to love (if you're a politician)?
dragonwriter 12y ago
> Why was it ever an option for states to create their own sites? Because the plans (as necessary because while the feds set some national standards, they have not displaced the states role as insurance regulators) are state-specific, and the exchange is supposed to provide gateways to both the state-specific insurance plans and the state-specific (and state-operated) Medicaid plans, and because it can also serve additional, related, state-specific functions. The option to fallback to a federally-facilitate marketplace (which, even if it is a shared website for many states, is still state specific) was originally envisioned as the least preferred option for a state exchange.

jobu 12y ago

Some failed and some did well. Connecticut did such a good job that other states (Maryland) are buying it. http://www.npr.org/blogs/health/2014/02/27/283526215/connecticut-looks-to-sell-its-obamacare-exchange-to-other-states http://www.npr.org/blogs/health/2014/02/27/283526215/connect...

SEJeff 12y ago

Kentucky created their own exchange and have been the poster child for ACA success as a result. It is super ironic given how anti-democratic / anti-obama the state is (I'm from KY, but live in Chicago): http://www.thedailybeast.com/articles/2013/10/17/obamacare-is-winning-in-kentucky-thanks-to-steve-beshear.html http://www.thedailybeast.com/articles/2013/10/17/obamacare-i...