Washington Post:

In public, the board overseeing Cover Oregon is scheduled to vote Friday whether to join the federal insurance marketplace that sells health plans in most of the country under the Affordable Care Act. Behind the scenes, the officials say, federal and Oregon officials already have agreed that closing down the state marketplace is the best path to rescue what has been the country’s only one to fail so spectacularly that no resident has been able to sign up for coverage online since it opened early last fall.

The collapse of Oregon’s insurance marketplace comes as federal health officials are focusing intensely on faltering exchanges in two other states, Maryland and Massachusetts.

This month, the board of the Maryland Health Connection became the first in the nation to decide to replace most of its exchange with different technology. But Maryland did not obtain required federal approval before its vote. Federal officials remain uncertain whether the state exchange has the capacity to correct its problems and have not indicated whether they will give Maryland the $40 million to $50 million it says it needs to make the switch.

Massachusetts was in the vanguard of insurance exchanges, opening its own years before the 2010 federal health-care law. But the commonwealth’s insurance marketplace developed severe technical problems as it tried to make adjustments to interact with the federal system.

Taken together, the federal uneasiness about these and other failing state insurance exchanges is emerging now that the federal Web site, HealthCare.gov, is largely functional, attracting unexpectedly large numbers of people in the final weeks of the first sign-up period, which just ended. So far, about 8 million Americans have enrolled through the federal and state marketplaces.

The fate of these state-run exchanges has significance both politically and for consumers.