Nevada invests in rule eligibility engine with the latest federal health insurance exchange grant

Nevada, Illinois, Washington, Tennessee, South Dakota and Oregon – six US states will receive $181 federal grant for the federal government to set up their health insurance exchanges. With this grant, the total value for the federal grant allocated to US states for setting up state health insurance exchanges, has reached $1.1 billion over the last two years. Till now 34 US states have received federal grant money from the US government for setting up insurance exchanges.

While five of the six states - Tennessee, Oregon, Nevada, and Illinois & South Dakota have received Level 1 exchange establishment grant, Washington has received a Level II establishment grant. Washington is the second US state to have received the Level II grant, which is awarded to states that have shown progress in setting up health insurance exchanges. While the Level 1 establishment grant is applicable for 1 year, states that are awarded Level II establishment grant are applicable to receive federal funding for multiple years.

The federal government allows US states to apply for more federal grants is the states require so, until the end of the year 2014 – the year when state health insurance exchanges are scheduled to launch. The funding have been allocated to help states quickly set up functional models of health insurance exchanges, in order to serve their residents better.

As the US Dept. of Health and Human Services (HHS) has given the states autonomy to design their health exchanges as they deem best fit to their local residents, Nevada has requested for a grant to set up a rules-eligibility portal that would help users determine eligibility for various healthcare assistance programs such as Children Health Insurance Program (CHIP), Medicaid and also for determining eligibility for purchasing insurance off the exchange.

If a US state decides to operate its own health exchange or run one in partnership with the federal government, then the states need to submit their exchange implementation plans – including a demonstration of operational readiness - by January 1, 2013 so that the states have sufficient time to set up their health insurance exchanges before the exchange launch deadline of January 1, 2014.

There is still a lot of doubt about whether the Affordable Care Act would survive the Supreme Court's ruling. If the law gets repealed, the individual mandate clause would be held unconstitutional too, and the 26 US states that have filed for lawsuits against the health insurance exchanges are likely to halt their health insurance exchange implementation processes. Much depends on the Supreme Court ruling, but until the ruling is declared, the states are expected to comply with the federally imposed ACA mandates.