The HHS grant received by Kentucky is one of a total of $229 million in establishment grants awarded to 10 states this week to help build health insurance marketplaces. The work that will be supported by the grant funds is necessary to comply with the federal ACA regardless of whether the exchange is operated by the state or the federal government. Kentucky will use its grant to continue the state’s health insurance exchange planning efforts. These efforts include creating a business and sustainability plan, program integrity plan, a Medicaid Implementation Advanced Planning Document, and will help build an end-to-end eligibility and enrollment system to serve both Medicaid and exchange participants. The grant funds, along with a $50 million project in the Governor’s Recommended budget (HB 265), will provide funding toward meeting the Medicaid eligibility requirements under the ACA. The most significant functionality requirements for health insurance affordability programs involve the Medicaid Program and relate to the expansion of eligibles and the associated simplified eligibility rules. Other requirements include easy, online access, real-time eligibility determinations, and enrollment for most Medicaid or KCHIP applicants, and the necessary interfaces with the Health Benefit Exchange, either federal or state operated. This grant will fund a significant portion of the state’s requirements with 100 percent federal funds, with the remainder of the requirements funded at a 90/10, federal-state matching rate.
“The Affordable Care Act requires that states put into place options for individuals and small businesses to access affordable health care,” said CHFS Secretary Janie Miller. “We are putting together the infrastructure needed to examine the insurance marketplace and, eventually, develop the technology needed to be able to compare plans and improve systems that support Medicaid eligibility for new individuals who will become eligible and an interface with an exchange to assure seamless transition for people.”
“Health insurance exchanges will make purchasing insurance easier for the public by providing eligible consumers and businesses with ‘one-stop-shopping’ where they can compare and purchase health insurance coverage,” said Carrie Banahan, executive director of the CHFS Office of Health Policy, who has been designated by Secretary Miller as the lead on this project. “Individuals and families purchasing health insurance through exchanges may also qualify for tax credits and reduced cost-sharing depending on their income.”
Kentucky previously received two federal health insurance exchange establishment grants totally $8.6 million. These grants provide states the necessary resources to conduct the research and planning needed to build a better health insurance marketplace and determine how exchanges will be operated and governed, including:· Assessing current information technology (IT) systems and infrastructure and determining new requirements;
· Planning for consumer call centers to answer questions from their residents;
· Determining the statutory rules needed to build the exchanges;
· Planning the coordination of eligibility and enrollment systems across Medicaid, the Children’s Health Insurance Program (CHIP), and the exchanges;
· Developing performance metrics, milestones and ongoing evaluation;
· Continue analysis of insurance markets and future market trends;
· Identify system requirements; and
· Add support staff.
To learn more about the Affordable Care Act please visit www.HealthCare.gov<http://www.healthcare.gov/> .