Skip to main content
  1. News
  2. Politics
  3. Government

Dispersed and diverse states of America: States-based insurance marketplaces

See also

From experience as program manager for a prime contractor that managed the states-based emergency system for advanced registration of volunteer health professionals, I learned much about America’s approach for address common health care needs. Until what was called the ESAR-VHP program, there were no national standards for credentialing healthcare professionals: doctors, nurses, and behavioral health professionals.

During the 911 disaster, volunteer health professionals showed up from area states and could not be deployed urgently because there was no way to verify their credentials. Hospitals could not accept volunteers, even if they were needed at once, until their credentials could be verified.

To develop national standards for credentialing health care professionals would take assembling representatives from each state and territory that would include medical professionals, lawyers from the states attorney generals. It would also require participation from a host of professional medical associations, each representing hospitals and individual health professionals as all of them are involved in states-based credentialing.

Exposed in the process is the variable and diverse levels of health care quality among the states. It is uneven with some states being leaders in healthcare and others being woefully deficient.

Of course, this situation applies to everything that we do in the United States. The quality of government services is tailored by communities and is most uneven. That is why when things like healthcare that are universally important to individuals rise to the level of needing a federal solution and national standard. That is what the Affordable Healthcare Act is truly about. While it focuses on serving those in dire need, it also addresses closing the gap in disparity in healthcare among the states, that is when and if Congress unites to get behind the need and necessity.

Today, the implementation of Obamacare is still what may be characterized as “I did it my way” States-based systems. The best shine such as Connecticut, and the failures stand out such as Maryland.

“Maryland set to replace troubled health exchange with Connecticut’s system

By Mary Pat Flaherty and Jenna Johnson, Published: March 28 E-mail the writers

Maryland officials are set to replace the state’s online health-insurance exchange with technology from Connecticut’s insurance marketplace, according to two people familiar with the decision, an acknowledgment that a system that has cost at least $125.5 million is broken beyond repair.

The board of the Maryland exchange plans to vote on the change Tuesday, the day after theend of the first enrollment period for the state’s residents under the 2010 Affordable Care Act.
Marylanders will be able to use the exchange even as it is being overhauled. The first enrollment period opened Oct. 1 and closes Monday for insurance coverage that kicks in this year. A second open enrollment period starts Nov. 15.

Like Maryland, Connecticut was one of the first and most enthusiastic states to embrace the idea of building its own insurance exchange rather than using a federal site to implement the law’s sweeping changes in health-care coverage.

But unlike Maryland, where the system crashed within moments of launching and has limped along ever since, Connecticut’s exchange has worked as smoothly as any in the country.

Maryland is not alone in having deep-seated problems with its health marketplace. Technical issues also have plagued Oregon, Minnesota and Hawaii. But Maryland will be the first to walk away from its site, a particular embarrassment for Lt. Gov. Anthony G. Brown (D), who was placed in charged of implementing health-care reform in Maryland by Gov. Martin O’Malley (D).

It was not immediately clear how much more money Maryland may have to invest to get a fully functioning system, according to the two individuals, who spoke on the condition of anonymity because they were not authorized to discuss the changes.

“A lot of states will be watching them and watching to see what they do,” Counihan said.”

http://www.washingtonpost.com/local/maryland-set-to-abandon-troubled-health-exchange-adopt-connecticuts-system/2014/03/28/ef6a3a3e-b6d2-11e3-8cc3-d4bf596577eb_story.html?wpisrc=al_comboPN

"State Decisions For Creating Health Insurance Marketplaces, 2014

Location, Marketplace Decision, Structure of Marketplace, Type of Marketplace

United States
17 State-based Marketplaces; 7 Partnership Marketplaces; 27 Federally-facilitated Marketplaces
NA
NA

Alabama
Federally-facilitated Marketplace
NA
NA

Alaska
Federally-facilitated Marketplace
NA
NA

Arizona
Federally-facilitated Marketplace
NA
NA

Arkansas
Partnership Marketplace
NA
NA

California
State-based Marketplace
Quasi-governmental
Active purchaser

Colorado
State-based Marketplace
Quasi-governmental
Clearinghouse

Connecticut
State-based Marketplace
Quasi-governmental
Clearinghouse

Delaware
Partnership Marketplace
NA
NA

District of Columbia
State-based Marketplace
Quasi-governmental
Clearinghouse

Florida
Federally-facilitated Marketplace
NA
NA

Georgia
Federally-facilitated Marketplace
NA
NA

Hawaii
State-based Marketplace
Non-profit
Clearinghouse

Idaho
State-based Marketplace1
Quasi-governmental
Clearinghouse

Illinois
Partnership Marketplace
NA
NA

Indiana
Federally-facilitated Marketplace
NA
NA

Iowa
Partnership Marketplace
NA
NA

Kansas
Federally-facilitated Marketplace2
NA
NA

Kentucky
State-based Marketplace
Operated by State
Not yet addressed

Louisiana
Federally-facilitated Marketplace
NA
NA

Maine
Federally-facilitated Marketplace2
NA
NA

Maryland
State-based Marketplace
Quasi-governmental
Clearinghouse

Massachusetts
State-based Marketplace
Quasi-governmental
Active purchaser

Michigan
Partnership Marketplace
NA
NA

Minnesota
State-based Marketplace
Quasi-governmental
Clearinghouse

Mississippi
Federally-facilitated Marketplace3
NA
NA

Missouri
Federally-facilitated Marketplace
NA
NA

Montana
Federally-facilitated Marketplace2
NA
NA

Nebraska
Federally-facilitated Marketplace2
NA
NA

Nevada
State-based Marketplace
Quasi-governmental
Clearinghouse

New Hampshire
Partnership Marketplace
NA
NA

New Jersey
Federally-facilitated Marketplace
NA
NA

New Mexico
State-based Marketplace4
Quasi-governmental
Not yet addressed

New York
State-based Marketplace
Operated by State
Active purchaser

North Carolina
Federally-facilitated Marketplace
NA
NA

North Dakota
Federally-facilitated Marketplace
NA
NA

Ohio
Federally-facilitated Marketplace2
NA
NA

Oklahoma
Federally-facilitated Marketplace
NA
NA

Oregon
State-based Marketplace
Quasi-governmental
Active purchaser

Pennsylvania
Federally-facilitated Marketplace
NA
NA

Rhode Island
State-based Marketplace
Operated by State
Active purchaser

South Carolina
Federally-facilitated Marketplace
NA
NA

South Dakota
Federally-facilitated Marketplace2
NA
NA

Tennessee
Federally-facilitated Marketplace
NA
NA

Texas
Federally-facilitated Marketplace
NA
NA

Utah
Federally-facilitated Marketplace5
NA
NA

Vermont
State-based Marketplace
Operated by State
Active purchaser

Virginia
Federally-facilitated Marketplace2
NA
NA

Washington
State-based Marketplace
Quasi-governmental
Clearinghouse

West Virginia
Partnership Marketplace
NA
NA

Wisconsin
Federally-facilitated Marketplace
NA
NA

Wyoming
Federally-facilitated Marketplace
NA
NA

http://kff.org/health-reform/state-indicator/health-insurance-exchanges/

Advertisement

News

  • Gaza school shelled
    Israeli airstrikes topple a school in Gaza suspected of housing rockets; dozens killed
    Video
    Video
  • Ebola outbreak
    An American with Ebola virus died shortly after boarding three planes
    World News
  • Why dogs smell butts
    Researchers figure out why dogs like to smell each other's butts
    Pets
  • Time to stop tanning
    The surgeon general advises us not to tan as melanoma cases are on the rise
    Health News
  • Zimmerman lands dream job
    George Zimmerman lands his dream job as a security guard at a gun/motorcycle shop
    Headlines
  • 10 smartest states
    Here are the 10 most educated states in the U.S., did yours make the cut?
    US News

Related Videos:

  • Border bill
    <div class="video-info" data-id="518332935" data-param-name="playList" data-provider="5min" data-url="http://pshared.5min.com/Scripts/PlayerSeed.js?sid=1304&width=480&height=401&playList=518332935&autoStart=true"></div>
  • Inside the box politics
    <iframe width="600" height="450" src="//www.youtube.com/embed/hOPqy_XdwNE?rel=0?rel=0&amp;VQ=HD720&amp;allowfullscreen=true&amp;autoplay=1"></iframe>
  • Putin
    <div class="video-info" data-id="518326303" data-param-name="playList" data-provider="5min" data-url="http://pshared.5min.com/Scripts/PlayerSeed.js?sid=1304&width=480&height=401&playList=518326303&autoStart=true"></div>