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The Supreme Court ruling upholding subsidies on the federal health-insurance exchange may prompt state-run exchanges to forge regional networks or use the federal marketplace.

Many of the dozen states operating exchanges under the Affordable Care Act are encountering financial strains, and could join the three dozen states already using the federal marketplace, HealthCare.gov. Some policy experts say it’s possible most of those states will eventually do just that, creating a largely national exchange program.

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