Inside Health Reform interviewed Manatt's Joel Ario, a managing director with Manatt Health Solutions, for an article on the likelihood that states use the federal marketplace rather than moving to create their own exchanges after the U.S. Supreme Court's ruling in King v. Burwell. States with their own exchanges are also more likely to turn to the federal technology than a private vendor.
"With Hawaii's transition to Healthcare.gov for 2016 open enrollment, we will have 38 states using the federal technology platform, BUT that does not mean 38 federally run states," said Ario. Four states explicitly retain state exchange status, meaning they oversee their own insurance markets and consumer protection efforts. Many more work in active or quiet partnership with the federal government. In fact, 45 of the 50 states have been approved as "effective rate review" states under the ACA, he said.