Most States Shun Fed HIX Partnerships, But Seek Accommodations

Friday's deadline is likely a soft one. The federal government, possibly anxious to get out from under the unexpected heavy lifting it's left with for crafting and running these exchanges, has said states can change their exchange model at any time. Depending on its response to Virginia, Ohio, and South Dakota, more states may seek accommodations rather than a change in status.

With states' insurance exchange models settled for now, Pearson says she expects a strong response from health plans despite the plans being a "little wary" of a federally run exchange.  

"I have definitely heard some plans express concern because the federal government has said things like 'We may apply a meaningful differences policy in future years,' where they would actually limit the number of products they offered," says Pearson.

"It's that kind of propensity to take a more active approach in the future or change the rules that makes them uncertain of the federal exchange. On the flip side, there is some efficiency for a plan to engage with the federal exchange because it's going to have a standard application template, a standard way of doing things."