The individual exchange open enrollment has now ended, and many interested groups and parties are beginning to assess the cost, impact, and success or failure of the Affordable Care Act public exchanges in the first year of launch. New Hampshire participates in the federal exchange, but many states chose to run their own exchanges. Several states had high profile failures of their exchanges, and two states (Maryland and Oregon) have already thrown in the towel. Massachusetts is also considering whether or not to give up on their state exchange, and join the federal exchange. New Hampshire exceeded their goal by enrolling over 40,000 people, nearly double of what they had anticipated and projected.
Massive amounts of money were spent on exchange infrastructure, and at least two US senators (Hatch and Barrasso ) are proposing seeking refunds from states that recieved grants to establish their programs, but have nothing but failure to show for it. In addition, the law will be a major campaign issue heading into this fall’s election season.
One of the first cost assessments is a report written by former Missouri Insurance Commissioner Jay Angoff, demonstrating that enrolling consumers in health insurance through the federally run exchange cost an average of $647 each, compared with $1,503 per enrollee in state-run exchanges. Angoff said costs ranged from a low of $76 per enrollee in Florida, which used the federal exchange, to a high of $23,899 per enrollee in Hawaii! This is all in addition to the cost of the policies themselves.