What if an exchange quits?

States that set up health insurance exchanges could shut them down at any time, and plans sold through them could disappear as well.

Officials at the Centers for Medicaid & Medicare Services refer briefly to those possibilities in a paperwork review notice for efforts to set up the Patient Protection and Affordable Care Act exchange program.

CMS officials noted that PPACA includes a section that explains what to do if a state decides to shut down a state-based exchange program after 2014.

The state would have to notify HHS of the decision, CMS officials said.

CMS officials don’t think it has to estimate the size of the burden for a state sending an exchange termination notice, because they don’t see that happening.

“We anticipate that few states with existing state-based exchanges will opt to terminate exchange operations after 2014,” officials said.