Nearly half of the 17 insurance marketplaces set up by the states and the District under the ACA are struggling financially, which creates even more pressure on the upcoming Supreme Court decision over the federal exchanges. Oregon is already out but Connecticut is succeeding, and there are a lot in between, but mostly leaning toward failure. Signups for the state marketplaces rose a disappointing 12% while those in the federal exchange rose 61%. In Minnesota and Vermont officials are so fed up with costly technical problems that they are considering handing over some or all of their functions to the state or federal governments. In Rhode Island, the legislature is considering a fee on health plans that would rise or fall depending on how costs go, and in Hawaii they already need another $28 million to fund operations until 2022.