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HHS Offers New Round of Marketplace Establishment Grants



This week in Washington—HHS announces additional round of exchange establishment grants and Medicaid DSH was discussed at MACPAC’s January public meeting. You are tuning in to the National Association of Public Hospitals and Health Systems health policy update for the week of Jan. 21, 2013.

The U.S Department of Health and Human Services (HHS) on Jan. 17 awarded $1.5 billion in exchange establishment grants to 11 states. The grants aim to help states build their affordable health insurance exchanges. Of note, HHS has started to refer to the exchanges as affordable health insurance marketplaces. Level One exchange establishment grants, which are one-year grants to help build the marketplace, were awarded to Delaware, Iowa, Michigan, Minnesota, North Carolina and Vermont. Level Two grants went to California, Kentucky, Massachusetts, New York and Oregon. The multi-year Level Two grants help implementation in states that are further along in the development of their exchanges. With this latest round of grants, 49 states, the District of Columbia and four U.S. Territories have received exchange grants. Grants are available to states through the end 2014.

More information about the health insurance marketplaces can be found at This website was launched to aid consumers as they look for information about the marketplaces and how to purchase plans within the marketplaces.

Also last week, the Medicaid and CHIP Payment and Access Commission (MACPAC) held their public meeting. One of the topics covered was Medicaid disproportionate share hospital (DSH) payments, and NAPH had the opportunity to make a statement at the meeting. NAPH urged the commissioners to keep the patients that DSH payments serve in mind as they work in the coming months. NAPH recommended that the DSH reduction methodology be developed in two phases. In the early years, the methodology for the DSH cuts included in the Affordable Care Act (ACA) should focus on the targeting prong of the ACA language. This would encourage states to direct DSH funds to those hospitals that have a high need for it and would allow time for data to accurately reflect the impact of the ACA expansion provisions. NAPH also urged the commissioners to keep in mind the intent of the DSH program and ensure that any methodology directs funds to hospitals with high levels of uncompensated care and, thus, the highest need for DSH.

Thanks for listening to another edition of This Week in Washington. I’m Zina Gontscharow; join us next week for another update.



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