Cleaning out the In Box: Illinois still might set up state exchange; SD & IA held hostage by a single insurer; VT website going offline surprised legislators

My in box is once again flooded with ACA-related stories which are interesting but which I just don't have time to do full write-ups on...

ILLINOIS: Clock Ticking For Illinois To Form State-Run Obamacare Exchange

Unless Illinois acts quickly, it will leave hundreds of millions of federal dollars on the table that would go toward building its own health insurance marketplace, potentially upping the cost of coverage for nearly 170,000 Illinois residents. State lawmakers, unable to break a years-long standoff, have not passed a law authorizing a state-based exchange, the marketplaces created under the Affordable Care Act that allow consumers to compare and buy health coverage, often with the help of federal tax credits. As a result, Illinois was one of 36 states that relied on the federal government to host its marketplace on HealthCare.gov, the website that survived a disastrous launch late last year to enroll about 217,000 Illinoisans, 77 percent of whom received federal help.

IOWA & SOUTH DAKOTA: A Single Insurer Holds Obamacare's Fate In 2 States

Iowa and South Dakota are the two states where the ACA insurance marketplaces have struggled the most. In both states, just 11.1 percent of residents eligible for subsidized insurance signed up for it — the lowest rates in all 50 states and the District of Columbia, according to data from the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

What happened in Iowa and South Dakota? The answer lies in commerce, not politics.

The individual insurance market in both states is dominated by one insurer, Wellmark Blue Cross and Blue Shield. Wellmark BCBS chose not to sell on the ACA exchanges in the first year, locking out its consumers from buying subsidized plans from the company. And it has decided to stay out of the Iowa and South Dakota exchanges for Year 2.

VERMONT: Exchange Shutdown Catches Lawmakers By Surprise

Chittenden Sen. Ginny Lyons is the chairwoman of the Legislature’s Health Care Oversight Committee. And she says that security shortcomings on Vermont Health Connect warranted the decision earlier this week to temporarily shut it down.

But Lyons says legislators were caught flat-footed by a surprise announcement of bad news from the administration of Gov. Peter Shumlin.