The U.S. Department of Health and Human Services (USDHHS) announced on May 23 that Indiana, Rhode Island, and Washington are the first states to win health insurance exchange establishment grants under the Affordable Care Act (ACA). The Indiana Family and Social Services Administration (FSSA) won $6.9 million to support health IT, project management, and legal, financial, actuarial, and policy support needed to establish its exchange.  The Rhode Island Department of Business Regulation won $5.2 million for health IT, developing a consumer support program, and business operations.   The Washington State Health Care Authority won $22.9 million for health IT and options analyses related to establishing its exchange.   The award amounts are based on the specific needs of each state as identified by the state through its initial planning.  Washington has already enacted legislation (S.B. 5445) to establish an exchange, Rhode Island legislation (S. 0087) has been passed by the Senate, and Indiana is moving forward under an Executive Order signed by Governor Mitch Daniels.
       
This is the first in six rounds of exchange establishment grant awards.  Applications for the second round will be due June 30. Round six will be completed next summer. These exchange establishment grants follow $49 million in exchange planning grants last year to 48 states and the District of Columbia, and $241 million in early innovator exchange grants on February 16 to six states and a consortium of five New England states led by the University of Massachusetts Medical School. The early innovators are expected to create, implement, and share health IT with other states.  The planning, establishment, and early innovator grants under the ACA are designed to help states that elect to run state-based exchanges to achieve federal certification of their exchanges by January 2013 and to achieve operational status before January 2014 when they will begin to serve as virtual marketplaces through which uninsured individuals and small businesses can purchase health insurance coverage.