HHS disbursed a substantial amount of money to key states this past week in order to further their efforts in creating state health benefit exchanges or establishing a partnership exchange with the federal government. The states of California, Connecticut, Hawaii, Iowa, Maryland, Nevada, New York, and Vermont were all awarded exchange establishment grants on August 23.
California, Hawaii, Iowa, and New York were awarded Level One Exchange Establishment grants, which provide one year of funding to states that have begun the process of building their exchange. Hawaii and California have passed laws creating their state exchanges, and in New York Governor Cuomo has signed an executive order to create an exchange since bills to do so failed. However, in Iowa, exchange legislation has failed for the past two years and there is no executive order in place to create one. Given the November 16, 2012 deadline for states to submit their exchange blueprints to HHS for review and the lack of clear authority in Iowa for a solely state-based exchange, we can assume these funds will be used by the state to help facilitate a partnership exchange.
The states of Connecticut, Maryland, Nevada, and Vermont were awarded Level Two Establishment grants, which are provided to states that are further along in building their exchange and offers funding over multiple years. All of these states have exchange legislation passed and are well on their way to creating state-based exchange marketplaces without federal assistance (other than financial, of course!).