According to the report, billions of federal dollars went into these health insurance marketplaces, so they now have to “act like true marketplaces and start paying for themselves.”
In some states, fees are being imposed on plans, while in others costs are being spread out wider, according to the report.
For instance, Rhode Island is unable to pay for long-term operations of its health insurance exchange, HealthSourceRI, and state lawmakers have suggested the state transfer to the federal exchange, according to the report. The cost to operate the state’s exchange has been estimated at $17 million a year as well as $24 million a year, according to the report.
In New York, the state is relying on two agencies’ general revenue to fund its insurance marketplace, and in Maryland, there is currently a 2 percent tax on insurance plans, according to the report.
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