And the winners are . . .

By Deepak Madala

Last week, HHS awarded $765 million in exchange establishment grants to eight states: California, Connecticut, Hawaii, Iowa, Maryland, Nevada, New York, and Vermont. These grants support the costs associated with creating exchanges in these states.

There are two levels of exchange establishment grant funding that states can apply for. Level One grants are designed to support one year of planning for a state’s role in operating a health insurance exchange. States can apply for multiple Level One grants.

States that have developed longer term plans for implementation can apply for a multi-year Level Two grant. Level Two grants are often larger awards, and they are designed to provide enough funding to see the state through the entire exchange implementation process. According to CCIIO, these Level Two grant funds can be used to plan and launch consumer outreach efforts, which can include first-year expenses. In this most recent round of funding, Connecticut, Maryland, Nevada, and Vermont joined Washington and Rhode Island as the only states to have successfully received Level Two establishment grant funding.


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

  • California ($196,479,629) – This is California’s second Level One grant. California’s enrollment-related plans include developing policies for enrollment and eligibility, implementing a public education and outreach program, and submitting the Exchange Blueprint to get federal certification for a state-based exchange.
  • Connecticut ($107,358,676) – This Level Two grant will allow Connecticut to hire staff and consultants to manage the activities related to the creation and ongoing operations of a state-based exchange through 2014.
  • Hawaii ($61,815,492) – This is Hawaii’s second Level One grant. Hawaii will use some of this grant to hire new staff to support outreach as well as public education and other consumer assistance tools that are needed in its state-based exchange.
  • Iowa ($26,623,003) – This is Iowa’s second Level One grant. Iowa will use this additional funding to further develop and enhance the eligibility system redesign that was initiated with its first Level One grant.
  • Maryland ($123,048,694) – Maryland plans to use this Level Two funding to complete all the necessary activities to achieve certification by January 2013 and to begin enrolling individuals through a state-based exchange for coverage effective January 1, 2014. These activities include program integration with state and federal agencies, stakeholder engagement, consumer assistance, as well as outreach and education.
  • Nevada ($50,016,012) – Nevada plans to use this Level Two funding to meet certification requirements in January 2013 and to provide coverage to enrollees by January 1, 2014. The state intends to provide the same customer experience to all individuals seeking coverage, regardless of the source or amount of subsidy for which they may qualify, or the door through which they enter.
  • New York ($95,496,490) – This is New York’s third Level One grant. New York will use its new funding to further several enrollment-related activities, such as researching a campaign to educate enrollees in preparation for open enrollment in October 2013, developing the back-end operations of the exchange’s call center, and creating an overall strategy to provide customer support and consumer assistance.
  • Vermont ($104,178,965) – Vermont plans to use this Level Two funding to meet the state-based exchange certification requirements in January 2013 and to prepare for open enrollment in October 2013. The state will also use the funding to implement an outreach and training strategy.

Applications for the next round of exchange establishment grants will be due on November 15, 2012.


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