On February 5, 2018, the Center for Consumer Information and Insurance Oversight (CCIIO) released a new Notice of Funding Opportunity to support states as they implement several of the market reforms and consumer protections under Title I of the Affordable Care Act (ACA). This grant program is a follow-up to the Health Insurance Enforcement and Consumer Protections Grants funded in 2016. Specifically, the new grant program – known as the State Flexibility to Stabilize the Market Grant Program (“State Flexibility Grant Program”) – is intended to provide states with the opportunity to ensure their laws, regulations, and procedures align with federal requirements. Specifically, the State Flexibility Grant Program seeks to enhance states’ ability to regulate their markets relative to the following federal protections:
- Guaranteed availability of coverage
- Guaranteed renewability of coverage
- Essential Health Benefits (EHB)
Funding under the State Flexibility Grants can be used for:
- Implementing or enhancing policy form review
- Developing procedures and/or tools to identify discriminatory benefit designs
- Hiring or contracting with a clinician to review formularies
- Developing actuarial or economic analyses
- Performing market scans to ensure compliance and improve and expand coverage options
- Reviewing the state’s EHB benchmark plan and considering new options
- Other activities that fulfill grant requirements
Total funding available nationwide is $8.1 million and CCIIO will announce funding allocations based on letter of intent submissions by March 2, 2018. Mandatory letters of intent were due February 26, 2018 and grant applications are due on April 5, 2018. Grants will cover June 6, 2018 through June 5, 2020.
As states explore the opportunities of the State Flexibility Grant Program and begin to develop their grant applications, this recent PCG article offers insight into the suggested activities for grant applications and highlights some of the innovative activities taking place in states across the U.S.
More information about the new Notice of Funding Opportunity and the 2016 Health Insurance Enforcement and Consumer Protections Grants is available at:
https://www.cms.gov/CCIIO/Resources/Funding-Opportunities/Downloads/Grants-to-States-Added-Flexibility-2018.pdf
https://www.cms.gov/CCIIO/Resources/Funding-Opportunities/Downloads/The-Health-Insurance-Enforcement-and-Consumer-Protections-Grant-FOA-6-15pdf.pdf
Lisa Kaplan Howe (J.D.) is a Senior Advisor who has spent her career working in health law and policy. At PCG, she focuses on statutory and regulatory analysis and strategic advising, particularly related to health care policy. Lisa has provided subject matter expertise to support state health care reform efforts, including policy development and regulatory support for health insurance Marketplaces and state insurance plan management efforts, Medicaid expansion and Medicaid Waivers (including DSRIP Waivers) and State Innovation Waivers. Lisa led PCG’s work with the New Hampshire Insurance Department relative the state’s Section 1115 Medicaid Waiver to provide coverage to newly-eligible adults through the Marketplace and continues to support the states’ Marketplace plan management work. In those roles, Lisa has served as the chief advisor and policy expert related to Medicaid and private insurance law to the New Hampshire Insurance Department, helping to identify, analyze and lead strategic consideration of federal opportunities and requirements. Lisa is also part of the team helping to design Colorado’s Delivery System Reform Incentive Payment (DSRIP) program. Ms. Kaplan Howe also provides broad policy and regulatory support to PCG’s other health care clients across the country, analyzing policy and regulatory developments, providing strategic advice relative to regulatory questions, and drafting policy briefs and position papers. Lisa is a managing editor of PCG’s monthly health practice area newsletter, Health Policy News.
Prior to joining PCG, Lisa served as Policy Director at New Hampshire Voices for Health, where she led legislative and regulatory analysis, strategic planning, and implementation of the organization’s policy agenda. Her work included drafting bills, amendments, testimony, and communications and testifying at hearings. Lisa also held the positions of Private Market Policy Manager and Consumer Health Policy Coordinator at Health Care for All of Massachusetts. While there, she managed private insurance market policy work and was a member of the organization’s internal health reform team. Lisa also practiced law in the Ropes & Gray health care department, advising health care provider and insurer clients.
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