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

The Department of Health and Human Services Centers for Medicare and Medicaid Services is funding state-level activities to modernize Essential Health Benefits benchmark plans under CFDA 93.679, with a grant opportunity (CMS-2U2-25-001) due January 15, 2025.

This is a newly active program. The most recent grant opportunity was posted October 17, 2024, and targets the 24 of 28 states operating on Federally-facilitated Exchanges that have not updated their EHB-benchmark plans since the program's inception. The program funds three core activities: comprehensive review of EHB-benchmark plans, solicitation of public feedback on state EHB coverage, and preparation and submission of applications to CMS to modify the EHB under 45 CFR 156.111. The objective is to align Qualified Health Plans offered through state Exchanges with recent medical evidence, scientific advancement, and clinical care guidelines, and to reduce barriers to EHB access driven by cost, claims denials, utilization management, or discriminatory benefit design.

Eligible applicants are state governments with a Federally-facilitated Exchange. The program awards grants, with no other assistance types indicated in the current opportunity.

The source does not provide grant award portfolio data, concentration analysis, award economics, or prior award history. No recent grant awards are documented; this appears to be a newly established program with its first solicitation cycle. The current NOFO indicates CMS posted a final NOFO with updated application due dates, suggesting iteration on the initial solicitation structure.

The January 15, 2025 due date is the next actionable deadline for applicants in states operating FFEs without a current EHB-benchmark plan modernization effort underway.