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In March 2010, the federal Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 were signed into law. Together, these two laws are collectively referred to as the Affordable Care Act and include a wide variety of provisions designed to expand coverage, to provide more health care choices, to enhance the quality of health care for all Americans, to hold insurance companies more accountable, and to lower health care costs. Among its provisions, the law provides grant funding to assist states in developing and implementing Health Insurance Exchanges.
Beginning in 2014, Americans will have access to health coverage through newly established Exchanges in each state. Individuals and small businesses can use the Exchanges to purchase affordable health insurance from a choice of products offered by qualified health plans. Exchanges will ensure that participating health plans meet certain standards and facilitate competition and choices by rating health plans' quality. Individuals and families purchasing health insurance through Exchanges may qualify for premium tax credits and reduce cost-sharing if their household income is between 133 percent and 400 percent of the Federal poverty level. The Exchanges will coordinate eligibility and enrollment with State Medicaid and Children's Health Insurance Programs to ensure all Americans have affordable health coverage.
On September 29, 2010, Connecticut was awarded a one-year planning grant ($996,848) to plan for the design and implementation of a state health insurance exchange. The grant is designed to provide the research necessary for policy makers to make decisions regarding key policy questions, including:
Whether to establish two separate Exchanges, one for the individual health insurance market and one for the small employer health insurance market or to establish a single Exchange.
Whether to merge the individual and small employer markets.
The definition of small employers participating in the Exchange as one to 50 employees or one to 100 for calendar years 2014 and 2015.
Whether to allow large employers, defined as more than 100 employees, to participate in the Exchange beginning in 2017.
Whether to require participating insurance plans to provide the federally defined essential benefit package or include additional state mandated benefits.
Whether to delegate all or part of insurance plan certification to the Connecticut Insurance Department.
The relationship of the Exchange to insurance agents.
The capacity of the Exchange to award grants.
How to ensure that the Exchange is financially sustainable by 2015, as required by the Federal Act.
Exchange Planning Grant Report released (January 2012). This report, produced by Mercer Health and Benefits, LLC under contract with the Office of Policy and Management, provides projections and guidance related to the planning, research and data analytics that will help to establish the policy direction and implementation strategy for the State's Health Insurance Exchange.
CT Health Insurance Exchange Board Presentation 11/17/11
Exchange Planning Overview
What are Health Insurance Exchanges?
State Exchange Planning Grant Application
New England States Early Innovator Grant -- Information Technology
Connecticut has joined together with other New England states to participate in the Early Innovator Grant Project, funded by the U.S. Department of Health and Human Services.
The purpose of the Project is to create Health Insurance Exchange Information Technology components in Massachusetts that are consumer-focused, cost-effective, reusable and sustainable and that can be leveraged by New England and other states to operate Health Insurance Exchanges.
The Early Innovator Grant Project will create a learning collaborative, led by a multi-state steering committee, where participating states can share and develop cutting edge and cost-effective technology components, intellectual property and best practices for implementing an insurance exchange.
For more information:
On August 15, Connecticut was awarded a $6.7 million federal Level One Establishment Grant from the federal Center for Consumer Information and Insurance Oversight (CCIIO) to further its planning, development and design of an Insurance Exchange for the State.
Before Connecticut can successfully apply for "Level Two Establishment" funding to design a fully functioning Exchange by 2014, Connecticut needs to address additional core operational areas while completing planning research efforts. Level One grant funding enables Connecticut to focus on three necessary projects:
In August 2012, the CTHIX was also awarded a $1.5 million Level One Supplement grant to provide continued support for critical Level One project goals such as the establishment of administrative structure, internal financial management processes, and fulfilling contractual obligations.
On August 23, 2012 the CTHIX was awarded a Level Two Establishment grant for $107 million, marking a major milestone in Exchange development. Level Two grant funds will primarily drive the development of an IT system that will facilitate crucial Exchange functions such as eligibility, enrollment, and information exchange among individuals, employers, insurance carriers, and state and federal government agencies.
This category of grants provides funding through December 31, 2014 to applicant states that are further along in the establishment of an Exchange. States can use the Exchange establishment grants for a number of different activities including conducting background research, consulting with stakeholders, making legislative and regulatory changes, governing the exchange, establishing information technology systems, conducting financial management and performing oversight and ensuring program integrity.