Drumroll, please! For us techies (or techie-wanna-bes),
the waiting is over. And the envelope says…Kansas, Maryland, New York,
Oklahoma*, Oregon, Wisconsin and a multi-state consortia consisting of the New
England states (sans New Hampshire) are the winners. The awards ranged from a
low of $6.3 million for Maryland to a high of $54.6 million for Oklahoma.
According to www.healthcare.gov, the seven grantees were
selected based on their readiness to develop and use innovative information
technology (IT) approaches for the exchange IT systems. These systems will be
the foundation for accessing health coverage through the Affordable Care Act.
Exchange IT systems are expected to handle eligibility and enrollment in the
Exchange, as well as premium tax credits and cost-sharing limitations for
eligible families and individuals. These systems must be interoperable and
integrated with state Medicaid and CHIP programs.
The fact that only 7 projects were awarded grants
(originally, HHS planned to award 5) should not deter other states from
procuring the technology they need to run their own state exchanges. A critical
requirement for securing an innovator grant was the willingness to develop a
model that could be adapted by other states. States receiving grants are
expected to create a process that allows other states to follow the progress of
the project and adapt the model as it moves through the various phases of
design, development and implementation, rather than wait until the project is
Other states may include all reasonable technology costs
in their Exchange implementation grant applications. And, the Center for
Medicaid and Medicare Services (CMS) has proposed a short-term higher federal
match (90%) for enhancements and upgrades to Medicaid eligibility systems that
are needed for these programs to comply with the ACA and ensure
interoperability between the Exchange and state Medicaid and CHIP programs.
Thus, states have attractive options for financing these expensive and complex
Of course, despite how attractive 100% federal funding
for critical IT systems is, the big question is whether politics around health
reform implementation will impede any of these projects from moving forward.
After all, the grant proposals were submitted in December before the changeover
in leadership in many states. Just this week, it was reported that Wisconsin is
returning $238,000 in consumer assistance funds awarded from the ACA. It would
be a shame given that Wisconsin’s ACCESS system is recognized as one of the
leading Medicaid systems and that the state has already built a prototype of
the Exchange system.
* Editor’s Note: Oklahoma has since decided to return the grant to HHS.