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

Agency: Center for Medicare and Medicaid Services

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

Archived opportunityLast Updated: May 13, 2026

Description

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.

Eligibility

Eligible applicants

Government

State governments

Additional information

You are eligible for funding under this funding opportunity if you meet all of the following criteria:•You are a state government’s executive branch agency.•You regulate the non-grandfathered individual and small group health insurance markets in the state, even if any of the following are true:•The state does not have statutory authority to enforce the EHB requirements.•The state is not otherwise enforcing the EHB requirements, or CMS has determined that the state is not substantially enforcing the EHB requirements. •Your state must have an FFE as of January 1, 2026. The states expected to have an FFE as of January 1, 2026 are: AL, AK, AZ, DE, FL, HI, IN, IA, KS, LA, MI, MS, MO, MT, NE, NH, NC, ND, OH, OK, SC, SD, TN, TX, UT, WV, WI, and WY

Grantor contact information

Description

PMPolicy@cms.hhs.gov

Email

PMPolicy@cms.hhs.gov

Documents

File name	Description	Last updated
CMS-2U2-25-001_REV1_Final.pdf	EHB-Benchmark Plan Modernization Grant	Nov 13, 2024 08:50 PM UTC

Link to additional information

Archived: February 14, 2025

Application process

This site is a work in progress. Go to www.grants.gov to apply, track application status, and subscribe to updates.

Award

$--

Program Funding

Expected awards

$--

Award Minimum

$375,000

Award Maximum

Funding opportunity number:

CMS-2U2-25-001

Cost sharing or matching requirement:

Funding instrument type:

Grant

Opportunity Category:

Discretionary

Opportunity Category Explanation:

Category of Funding Activity:

Affordable care act

Category Explanation:

History

Version:

Posted date:

November 13, 2024

Archive date:

February 14, 2025