"States are really up against a wall here ...

... [under CMS's Feb. 29 final rule establishing a fee for state-based exchanges that now rely on the federal platform, initially equal to 1.5% of premiums but climbing to 3% in the future]. As we have seen, the cost of developing a state-specific platform for an individual [state-based exchange, or SBE] is high and comes with no small amount of risk. In comparison, a payment rate of 3% of premiums may look like a smart use of the money. Perhaps there is an opportunity for private entities or [exchanges] with successful systems to support those [SBEs] currently relying on the federal platform or considering moving in that direction."

— Helaine Fingold, senior counsel in the Health Care and Life Sciences practice at the law firm of Epstein Becker Green, told AIS's Inside Health Insurance Exchanges.