Six States Receive Exchange Establishment Grants

By Deepak Madala

Last week, HHS awarded $181 million in health insurance exchange establishment grants to Illinois, Nevada, Oregon, South Dakota, Tennessee, and Washington. Over the last two years, a total of 34 states and the District of Columbia have received grants to create their exchanges and to fund important enrollment-related functions, including building improved IT infrastructure to support exchange websites and eligibility systems, as well as planning public education and outreach efforts.

EstablishmentGrants May24

In this round of establishment grants, Washington became the second state to be awarded a Level Two establishment grant, which offers funding over multiple years to states that are further along in building their exchange. Rhode Island was the first state to receive a Level Two grant in November 2011. States can continue to apply for more rounds of exchange grants through the end of 2014, and they can use the funds through 2015. States are eligible to apply for the grants even if exchange legislation has not been enacted in the state or if the state plans to have a partnership or federally facilitated exchange. By January 1, 2013, HHS will evaluate all states’ progress toward creating an exchange. In states that will not have an operable exchange in time for the 2014 coverage year (which begins with the open enrollment period that starts on October 1, 2013), the federal government will assume responsibility for running a Federally-facilitated Exchange in the state. 


Here’s a quick round-up of enrollment-related work going on in the six states that received grants this round:

  • Illinois ($32,789,377) – This is Illinois’ second Level One grant. A portion of this grant will be used to continue developing a Consumer Assistance Portal for the Illinois exchange and a Navigator Education and Training Program.
  • Nevada ($4,397,926) – This is Nevada’s third Level One grant. Funds will be used to establish Nevada’s Silver State Health Insurance Exchange. This includes developing a rules-based eligibility engine that will serve as a single, streamlined eligibility process for all medical assistance programs; enhancing Nevada’s consumer assistance program; and engaging stakeholders such as Nevada’s Native American Tribal community.
  • Oregon ($6,682,702) – This is Oregon’s second Level One grant, and the state plans to use this grant to prepare for full federal certification of its state-based exchange in 2013. Oregon is participating in the Enroll UX 2014 project and has decided to develop a single web portal for the exchange and public programs. In order to qualify for full federal certification, the state must develop a “no wrong door” eligibility and enrollment system for the Oregon Health Plan (Medicaid), OHP Plus, Healthy Kids (CHIP), the Oregon Health Insurance Exchange, and all other public health coverage programs.
  • South Dakota ($5,978,569) – This is South Dakota’s first exchange establishment grant. The state is at the early stages of exchange planning and intends to use this grant to further its planning, research, and design of an exchange.
  • Tennessee ($4,300,000) – This is Tennessee’s third Level One grant. The state plans to use the funds to continue developing a state-based exchange. Like Oregon, Tennessee is also participating in the Enroll UX 2014 project.
  • Washington ($127,852,056) – Washington will use this Level Two funding to ensure that its exchange meets federal certification requirements in January 2013, provides coverage to enrollees by January 2014, and is self-sustainable by January 2015. Washington has already started the process of implementing a branding, outreach, and marketing strategy for its exchange.

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