The states of Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington will receive $181 million in grants from the Health and Human Services Department to help them establish health insurance exchanges.
This round of awards brings the total of exchange grants provided to states over the last two years to more than $1.1 billion, and 34 states and the District of Columbia have received establishment grants to further their progress toward building exchanges, according to a May 16 HHS announcement.
The state online marketplaces that aim to let consumers shop for and compare health coverage are scheduled to go live Jan. 1, 2014, under the health reform law. Deadlines for state exchange plans are fast approaching, including one for a state’s blueprint due later this year.
[See also: HIX deadline ‘less than 600 days’.]
Illinois, Nevada, Oregon, South Dakota and Tennessee have been awarded Level One Exchange Establishment grants, which provide one year of funding to states that have begun the process of building their exchange. Washington is the second state to be awarded a Level Two Establishment grant, which is provided to states that have demonstrated progress in building their exchange and offers funding over multiple years.
States can apply for more rounds of exchange grants through the end of 2014, and these funds are available for states to use beyond 2014 as they continue to expand functionality in their exchanges to serve their residents.
HHS also has a new map tool that breaks down what each state plans to do with its exchange funding. For example, Nevada is using its grant funds to develop a rules-based eligibility engine that will be the single, streamlined eligibility process for all medical assistance programs, including Medicaid, Children’s Health Insurance Program and the exchange. It will also prepare business and IT systems requirements for non-eligibility functions of the exchange.
[See also: Insurance exchange rule unveiled.]
HHS has also offered guidance to help states construct their exchanges. “In 2014, consumers in every state will have access to a new marketplace where they will be able to easily purchase affordable insurance,” said HHS Secretary Kathleen Sebelius.
HHS released an Exchange Blueprint that states may use to demonstrate how their exchange will work to offer a wide range of competitively priced private health insurance options. The blueprint also details the application process for states seeking to enter into a partnership exchange with the government.
If a state chooses to operate its own exchange or a partnership exchange, HHS will review and potentially approve or conditionally approve the exchange no later than Jan. 1, 2013, so it can begin offering coverage one year later.
States must submit a blueprint for approval during the fall of 2012 and demonstrate operational readiness through virtual or onsite readiness review, according to a May 16 announcement in the Federal Register.
If a state decides not to operate an exchange for its residents, HHS will operate a federally-facilitated exchange (FFE). The guidance describes how HHS will consult with a variety of stakeholders to establish such an exchange and how states can partner with HHS to handle selected functions in a federally facilitated exchange, and important policies organized by exchange function.
HHS will provide forums to help states with how to build exchanges. More information about health insurance exchanges is at http://cciio.cms.gov/programs/exchanges/index.html.