CCIIO updates state exchange information

The Center for Consumer Information & Insurance Oversight (CCIIO) has released an assortment of updates with regard to the new state exchanges to be implemented under the Patient Protection and Affordable Care Act (ACA).

First, six Level One Exchange Establishment grant awards, totaling more than $181 million, have just been awarded to Illinois, Nevada, Oregon, South Dakota and Tennessee. This brings the total of Exchange-related grants provided to states over the last two years to more than $1 billion. The grants are designed to provide one year of funding to states that have begun the process of building their Exchanges.

A Level Two Establishment grant has also been awarded, for the first time, to the State of Washington. Level Two grants are provided to states that are further along in building their Exchange and offers funding over multiple years.*

For those of you wondering how much has been given to each state, and what each plans to do with its funds, there is a state-by-state breakdown of grant awards
detailing what each state plans to do with its Exchange funding, at a new map tool on HealthCare.gov - www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html. Details such as the award amount, administrator, application due date, and level of funding are available, once you click on the map provided.

Next, guidance has also been issued in the form of a 45-page draft Exchange Blueprint, (under “Affordable Insurance Exchanges”, then “Forms” at http://cciio.cms.gov/resources/other/index.html#hie). States may use the Blueprint to demonstrate how their Affordable Insurance Exchange will work to offer a wide range of competitively priced private health insurance options. The Blueprint clarifies that states wanting to either operate state-based exchanges or participate in state partnership exchanges for 2014 must first declare the type of exchange model they intend to pursue through an Exchange Declaration Letter, and must complete an Exchange Application, details of which are provided in the Blueprint. The HHS will then review and potentially approve or conditionally approve the exchange no later than January 1, 2013, so it can begin offering coverage on January 1, 2014.

Consumers in every state are to have access to coverage through an Affordable Insurance Exchange by Jan. 1, 2014, advises the CCIIO. If a state decides not to operate an Exchange for its residents, the Department of Health and Human Services (HHS) will operate a Federally-facilitated Exchange (FFE). Guidance describing how HHS will consult with a variety of stakeholders to implement an FFE, where necessary, how states can partner with HHS to implement selected functions in an FFE, and key policies organized by Exchange function can be found at a document entitled “General Guidance on Federally-facilitated Exchanges” at http://cciio.cms.gov/resources/regulations/index.html#hie (under “Affordable Insurance Exchanges”, then “Guidance”).
The HHS has scheduled some implementation forums in the coming months to work with states and stakeholders on their exchange questions, and it also plans to engage in consultation with Tribes, Tribal Governments, and Tribal Organizations on how exchanges can serve their populations.

Upcoming forums include Regional Implementation Forums in Washington, DC (July 18), Chicago (August 2), Denver (August 10), and Atlanta (August 15) and Tribal Consultations in Washington, DC (July 26), Anchorage (August 7), and Denver (August 9).

For a comprehensive analysis of the ACA, and additional information on health reform and other developments in employee benefits, just click here.


* In 2010, 49 states and the District of Columbia received Exchange Planning grants totaling more than $54 million; in 2011, seven states received more than $249 million in Early Innovator grants; and to date, 34 states and the District of Columbia have received more than $856 million in Establishment grants, says the CCIIO. Exchange grants can be applied for through the end of 2014, although the funds are available for use beyond 2014.