State health insurance exchanges mandated in the health care reform law--assuming they survive court challenges to the law--are getting federal funds to launch but must be self-sustaining afterward.

To succeed, the exchanges will have to find alternative sources of funding by 2015. The reform law, note authors of a new report from consulting and information technology services firm Computer Sciences Corp., "doesn't provide much guidance for this requirement, and given the fiscal uncertainty of state and local budgets, it seems unlikely that the federal funding will be replaced by pubic revenue from local sources."

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