The 14 states that are running their own health insurance marketplaces are supposed to pay for themselves starting next year, but there could be trouble ahead.
The federal government covered start-up costs until the exchanges could get off the ground.
But some may not be able to cover costs starting in 2016. Enrollments have been lower than expected, which means lower revenues.
Some states have said they might need more federal money, like Rhode Island.
Minnesota, Oregon and Washington have all pledged cost-cutting to stay out of trouble. And Washington state might increase its tax on insurance companies.
It's possible some of the states will be in better shape with big enrollment gains by March 31. That's when people have to sign up for insurance or face federal tax penalties.