The launch of the federally run marketplace in states that chose not to run their own marketplace was fraught with technical difficulties. In contrast, most states that opted to operate their own marketplace had few problems and claim to be successful. Given the contrast, many have been asking why the federally run marketplace struggled. At least part of the reason is that the original intention of the law was for every state to run their own exchange and so it was not anticipated that the federal government would run the marketplace in so many states. However, another criticism has been about the design of the site, which has been detailed in a recent new story, which you can access here. The main criticism is that the federal government required people to set up an account rather than being allowed to browse options before setting up an account. Washington state had issues launching their site, but have fixed those issues and now has been running successfully, which was detailed in a great news story here. It may be a lesson for the federal government. This shouldn’t be surprising because states are often described as policy laboratories where innovations happen that are then diffused to other states and sometimes, eventually, to the federal level.