The Center for Consumer Information and Insurance Oversight (CCIIO) announced on November 29 that it is awarding $220 million in health insurance Exchange establishment grants to 13 states under section 1311 of the Affordable Care Act (ACA). Twelve states (Alabama, Arizona, Delaware, Hawaii, Idaho, Iowa, Maine, Michigan, Nebraska, New Mexico, Tennessee and Vermont) received notification of “Level One” Exchange establishment grants and Rhode Island won a $58.5 million “Level Two” grant for seven projects building on progress that it achieved under “Level One.”  Rhode Island’s “Level Two” award is the first such award nationally.  These new awards follow “Level One” grants to 13 States and the District of Columbia on August 12, “Level One” grants to three States on May 23, seven “Early Innovator” grants, and earlier planning grants to nearly all States and Territories. CCIIO also extended the final deadline for “Level One” grant applications from December 31, 2011 to June 29, 2012 and released new guidance on key questions related to Exchange design, development, and funding. CCIIO indicates that Federal grant funding under the ACA may be used to establish State-based Exchanges, to build functions that a State elects to operate under a Federal/State Partnership Exchange, and to support State activities needed to create information technology interfaces with Federally-facilitated Exchanges.