Nearly half of the 17 insurance marketplaces set up by the states and Washington, D.C., under the Patient Protection and Affordable Care Act are struggling financially, according to The Washington Post.
The financial struggles are attributed, in part, to tepid enrollment numbers and growing costs, especially for balky technology and pricey customer call centers, according to the report.
Here are six things to know about these marketplaces and their future.
1. States have received nearly $5 billion in federal grants to establish the online marketplaces, according to the report. The report notes federal funding ended at the beginning of 2015, and exchanges now must cover their operating costs.
2. To help with the financial struggles, officials are looking at raising fees on insurers, and pressing state lawmakers for cash infusions, according to the report.
3. States have also made efforts to put themselves in a better financial position by sharing costs with other states. For instance, officials from Vermont, Rhode Island and Connecticut met recently to explore banding together in some sort of regional effort.
4. Some states are considering turning over part or all of their troubled marketplaces to HealthCare.gov.
5. King v. Burwell, the U.S. Supreme Court case that will decide the fate of subsidies in states where the federal government runs the health insurance marketplaces, will play a role in future decisions. If the subsidies remain in place for the federal exchange, some states might increase efforts to transfer operations to HealthCare.gov, according to the report.
6. Hawaii's exchange, which needs $28 million to cover operations until 2022, is one of the most problem-plagued marketplaces, officials have said, according to The Washington Post.
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