Health Insurance Marketplaces

Mr. Andy Slavitt
Acting Administrator
Centers for Medicare & Medicaid Services
U.S. Department of Health and Human Services
Hubert Humphrey Building, Room 445-G
200 Independence Avenue, SW
Washington, DC 20201

Dear Mr. Slavitt:

On behalf of the nation’s governors, we request your assistance in providing states with increased flexibility to improve access to quality, affordable health insurance. The attached recommendations provide specific federal actions to help address health insurance marketplace challenges and support governors’ coverage goals.

States across the coverage spectrum face challenges related to their marketplaces. In June, the National Governors Association Center for Best Practices (NGA Center) convened a roundtable of state leaders, senior federal officials and other national experts to highlight those challenges and explore possible solutions. During the discussion, states identified opportunities for the Centers for Medicare and Medicaid Services (CMS) to support their efforts in three key areas: maximizing state flexibility to oversee the marketplaces, enhancing data and information-sharing between states and the federal government and facilitating transitions between marketplace models. Governors appreciated CMS’s participation in the NGA Center roundtable and seek to foster continued dialogue by providing actionable recommendations in each of those areas.

Greater flexibility and continued collaboration with federal partners are essential to the success of state efforts to innovate and meet local coverage needs. We look forward to working with you to achieve those shared goals.


Governor Charlie Baker
NGA Health and Human Services Committee

Governor Maggie Hassan
Vice Chair
NGA Health and Human Services Committee