The federal government still has a lot of work to do to improve the performance of the 14 state-run health insurance exchanges that were set up as part of the Patient Protection and Affordable Care Act. 

In a report, the Government Accountability Office outlines a number of IT weaknesses that continue to prevent the system from meeting full expectations. However, much of the information upon which the report is based is not up-to-date. 

The audit reports, for instance, that as of November 2014, 7 of 37 states using the federally-run insurance marketplace were either not able to transfer health insurance applications between the state-run Medicaid system and a key component of the federal marketplace or had not tested their systems to see if they could do it. 

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