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New In the Journal: How Foundations Are Helping States Implement Health Insurance Exchanges



February 9th, 2012

This GrantWatch column in the just-released February 2011 issue of Health Affairs is full text, free access, to all readers.

As many of you are aware, under the Affordable Care Act of 2010, individuals and small businesses, as of 2014, will be able to compare health insurance plans and enroll in them through state-based marketplaces called exchanges. (See the column for some other helpful features of exchanges.)

The federal health reform law’s intent is for each state to run its own exchange, but the law also gives states an “out”: either partnering with the federal government on an exchange or letting the federal government run it for the state.

The GrantWatch column I wrote for that issue discusses how foundations around the country have been working to help states make decisions about and establish their health insurance exchanges—for individuals and/or small businesses.

The column first discusses national efforts, such as that of Community Catalyst’s Affordable Care Act Implementation Fund. Foundations supporting that initiative include the Atlantic Philanthropies, California Endowment, Nathan Cummings Foundation, Ford Foundation, Jacob and Valeria Langeloth Foundation, and Rockefeller Foundation.

GrantWatch also mentions a number of projects funded by the Robert Wood Johnson Foundation, as well as an exchange-focused section of the Henry J. Kaiser Family Foundation’s gateway web page called Health Reform Source. And there is more: I mention a Commonwealth Fund grant, and a report cofunded by the California Wellness Foundation and others.

Foundation-funded efforts in several states are also described. California, Colorado, Kansas, Missouri, New York, Ohio, and Rhode Island are highlighted. I mention how far these states have, or have not, progressed in establishing an exchange, as of December 28. The challenge in writing such a column is the possibility of having the information “overtaken by events,” a phrase I learned from my Dad. This is because, with exchanges, the situation in the fifty states is fluid, and states are at varying stages in their preparations.

Among the funders mentioned in the “State Efforts” section are the California HealthCare Foundation, Colorado Health Foundation, Sunflower Foundation, Missouri Foundation for Health, New York State Health Foundation, Health Foundation of Greater Cincinnati, Rhode Island Foundation, and many more.

This is just a sampling of foundations’ efforts, not a comprehensive list! If you know of other funders that have been supporting development and implementation of exchanges, please let me know—either by commenting below or sending me an e-mail, lprina@projecthope.org.

For information on states’ activities on exchanges, see the Kaiser Family Foundation’s factsheet that was updated January 18. Its map of state exchange efforts is current as of January 30.

Key Personnel News

The February GrantWatch column also includes some “people news.” Read about the new head of Grantmakers In Aging; the new president of the Greenwall Foundation, which now focuses solely on bioethics; the passing of Margaret (“Maggie”) Mahoney; and more.

Also in the February issue of Health Affairs:

Read about a cluster of articles, supported by the Commonwealth Fund, on Small Business Health Care Options Program (SHOP) exchanges. This type of exchange was authorized under the Affordable Care Act. Authors include Tim Jost, a professor at Washington and Lee University law school and a frequent blogger on Health Affairs Blog, and Jon Kingsdale, founding director of the Massachusetts Connector Exchange.

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