Washington became the second state to be award a Level II establishment grant -- multi-year funding reserved for states that are further along in developing their exchange, according to HHS. That Level II grant is for $127.9 million. Rhode Island (which is the subject of an ongoing Governing series tracking the creation of its exchange) was the first state to receive Level II funding back in September.
South Dakota, which participated in a constitutional challenge to the Affordable Care Act (ACA), received its first Level I establishment grant, worth $5.9 million. According to Governing's tally, 13 states that opposed the ACA in court have received grants to establish state insurance marketplaces created by the law.
Illinois, Nevada, Oregon and Tennesse were awarded an additional round of Level I grants.
States must demonstrate by Jan. 1, 2013, that they can operate an exchange (which open for enrollment in October 2013) or that they could manage a partnered exchange with the federal government. Otherwise, HHS will fully oversee the creation and management of a state's exchange.
So far, 34 states plus the District of Columbia (see map below) have received establishment grants, according to HHS.
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