A number of state-run PPACA health insurance exchanges have been struggling over the last year-plus. In fact, state-run health insurance exchanges in Oregon, Maryland, New Mexico, and Nevada have either permanently shut down their operations or have done so temporarily and are contemplating some attempts to relaunch them. Colorado, Minnesota and Vermont are now also considering abandoning their state programs.

One of the victims of these failures and potential failures in these states is the Small Business Health Options Program (SHOP), a program that was designed as part of the PPACA to help small businesses access affordable health insurance for their employees.

In late May, Hawaii's health insurance exchange became the latest one to bite the dust, taking its SHOP with it. The federal Centers for Medicare and Medicaid Services (CMMS) began restricting grant funds to the state's Health Connector two months ago, after telling state officials that the program was out of compliance with the Affordable Care Act due to fiscal instability and ongoing IT issues. One of these IT issues involved SHOP. According to a May 15 article published by Fox News, "The Connector's Small Business Health Options Program, targeted at small business owners, sent garbled data to insurers, preventing them from signing up small businesses and their employees."