EHB-Benchmark Plan Modernization Grant for States with a Federally-Facilitated Exchange

The summary for the EHB-Benchmark Plan Modernization Grant for States with a Federally-Facilitated Exchange grant is detailed below. This summary states who is eligible for the grant, how much grant money will be awarded, current and past deadlines, Catalog of Federal Domestic Assistance (CFDA) numbers, and a sampling of similar government grants. Verify the accuracy of the data FederalGrants.com provides by visiting the webpage noted in the Link to Full Announcement section or by contacting the appropriate person listed as the Grant Announcement Contact. If any section is incomplete, please visit the website for the Centers for Medicare & Medicaid Services, which is the U.S. government agency offering this grant.

EHB-Benchmark Plan Modernization Grant for States with a Federally-Facilitated Exchange: We know it can be challenging for states to fund the work necessary to improve the Essential Health Benefits (EHB). Improving EHB typically involves: Comprehensively reviewing EHB-benchmark plans. Seeking public feedback on the coverage of EHB in the state. Submitting an application to CMS to change the EHB in the state. We understand that, due in part to these challenges, that there are many states that have not considered updating their EHB-benchmark plans. These states include 24 of the 28 states expected to have a Federally-facilitated Exchange (FFE) as of January 1, 2026. As a result, the covered benefits in the Qualified Health Plans (QHPs) offered through the Exchanges in these states may not reflect recent changes in medical evidence, scientific advancement, and clinical care guidelines. Additionally, people enrolled in these QHPs may have trouble accessing EHB because of cost, claims denials, utilization management, discriminatory benefit design, or other factors. We want to lessen these challenges through the EHB-Benchmark Plan Modernization Grant for States with a Federally-facilitated Exchange (FFE EHB Mod Grant). This new grant program will fund states with an FFE for a variety of activities related to the review of EHB-benchmark plans. The goal is to help applicants modernize and change their EHB-benchmark plans under 45 CFR 156.111.