Think about it: At this point in the rollout of the Affordable Care Act, there are 36 states relying on the federal infrastructure of Healthcare.gov a site created by the U.S. Centers for Medicare and Medicaid Services once it became evident that many Republican-leaning states would not be creating their own state-run exchange infrastructure to comply with the health law. That leaves 15 states including the District of Columbia currently operating autonomously from the federally facilitated marketplace.
A recent article by POLITICO postulated whether this setup might turn into a national health insurance exchange, even by default, as two more states have opted into Healthcare.gov recently and even more state exchanges could fall apart given the stipulation that they cultivate their own funding and operate without federal monies in coming years.
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