Consulting: A new source of state revenue?

The Iowa state capitol.

Bad news seems to be the theme of the Affordable Care Act rollout. But Connecticut seems to be bucking that trend. The state has seen 55,000 people  sign up for health care on the state's website, far in excess of the federal government's goal of 33,000. The state has been so successful in fact, that it's starting a consulting business to help other states with their own websitesThe state's exchange, Access Health CT, is looking to either license or franchise the technology it used to create its website, making it much easier for states like Arkansas or Iowa to control their own health care policy while not having to hire a large staff.

While Connecticut's approach may be novel, it's not the first state to attempt to share successful projects and expertise with other states:

  • In September of last year, Michigan and Illinois teamed up to share their Medicaid Management Information System (MMIS). Every state is required by federal law to operate the technology that supports the back end of their Medicaid program. As Illinois was looking to update its 1970s era system, the state realized that Michigan already had a federally-certified MMIS in place. Conversations went back and forth and both states realized that by pooling their resources, they could save a lot of money. Now Michigan runs the Illinois MMIS, and the states will save an estimated $263 million on operational costs over a five-year period.
  • A non-profit called Results First is trying to get other states to implement the Washington State Institute for Public Policy’s approach to cost-benefit analysis. The WSIPP provides analysis and research to the Washington State Legislature, some of which has led Washington to focus more on crime-prevention and treatment programs. Results First, an initiative of the Pew Center on the States and the John D. and  Catherine T. MacArthur Foundation, is hoping to replicate the evidence-based policy approach in other states. So far, 14 states have signed up as partners.
  • However, examples like Washington’s policy analysis and Michigan's MMIS are not typical. Instead, states commonly function as "laboratories of democracy," in the words of former Supreme Court Justice Louis Brandeis. So when a state legalizes recreational marijuana, other states are certainly examining the roll-out intently. At a National Governors Association meeting in Washington, D.C., Colorado Gov. John Hickenlooper said that about six other governors asked him for his state’s experience. So it looks like the success of legal pot in Colorado might determine if there's legal pot elsewhere in the country.

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