Inside Health Policy interviewed Manatt's Joel Ario, a managing director with Manatt Health, for an article on CMS' proposed user fee rate of three percent for state-based marketplaces that use the federal platform. This is the first instance in which CMS has suggested a figure for how much issuers in states that "lease" federal technology should kick back for those services.
Ario said three percent is higher than expected and could deter more states from pursuing the supported exchange model. Federal officials were mulling setting the user fee rate in the mid-two percent range, Ario said, so the higher rate will eat up more of the exchanges' capital than local leaders had hoped. He noted that state-run exchanges can set their own rates, and tend to place them lower and have larger enrollee bases than FFM states.
Ario expects states that currently use the federal platform to protest the fee in their comments on the proposal.