Grants to States for Operation of Qualified High-Risk Pools
Active
- Assistance listing
- 93.780
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Grant awards
- 45 $336,101,144 in federal obligations
Program facts
- Assistance types
-
- Formula Grant
- Project Grant
- Block Grant
- Eligible applicants
-
- State (includes District of Columbia, public institutions of higher education and hospitals)
- Beneficiaries
-
- State
- Treasury account
-
- 75-0511-0-1-551
- More information
Program details come from SAM.gov Assistance Listings. Updated . Grant award figures come from USAspending.gov.
About this program
The Centers for Medicare and Medicaid Services (CMS) administers grants to states for the operation of qualified high-risk health insurance pools, CFDA 93.780, with no current grant opportunities open. The most recent award was made on August 23, 2013—more than thirteen years ago—signaling this program is effectively inactive for new applications.
This program funds the operational losses of state-administered health insurance pools designed to cover uninsurable or high-risk individuals. Awards have covered the Oregon Medical Insurance Pool, state comprehensive health associations, and reinsurance mechanisms across multiple states. A few awards also funded feasibility studies and actuarial analyses for establishing new high-risk pools in states without them.
The program operates predominantly as Formula Grants (93 percent of awards), with smaller shares of Block Grants (4 percent) and a single Project Grant (2 percent). All 45 awards in the portfolio were made by CMS alone. Combined federal obligated funding totaled $336.1 million across the program's history since 2004.
Award volume peaked in 2008, when 21 grants were disbursed to states with active pools. Individual awards ranged widely: Texas received $45.3 million in 2008, while smaller awards included Oregon at $1.4 million in 2013 and Wyoming at $3.5 million in 2008. Most awards contemplated 50 percent of the state pool's losses incurred during a fiscal year or the state's allotment under a formula, whichever was lesser.
With no award activity since August 2013, no recently posted opportunities, and no signals in the source material of program resumption, pursuit of this listing is not recommended. The program's underlying policy context—high-risk pool funding prior to the Affordable Care Act's expansion of coverage—has shifted fundamentally. Applicants would be limited to eligible states maintaining qualified high-risk pools and would submit via SF-424 forms to Gabriel Nah, Grants Management Specialist, at the CMS Office of Acquisition and Grants Management in Washington, D.C.
Objective and description
- Objective
To assist States in the operation of a qualified high-risk health insurance pool by providing Federal funding (for up to appropriate funding levels) of losses incurred by the pool for a given State fiscal year.
Eligibility
- Applicant eligibility
A State must meet all of the following requirements to be eligible for a grant: 1) the State is operating a qualified high-risk pool as defined in section 2744(c)(2) of the Public Health Service Act; 2) the pool restricts premium charged under the pool to no more than 200 percent for applicable standard risk rates for the State; 3) the pool offers a choice of two or more coverage options through the pool; 4) the pool has in effect a mechanism reasonably designed to ensure continued funding of losses incurred by the State; and 5) Grant Awards: FY 2012 - The Consolidated Appropriations Act, 2012. (Public Law 112-74), provided $43.197 million to 31 States; FY 2013 - The Consolidated and Continuing Appropriations Act, 2013 (Public Law 113-6), which provided $41.756 million to 31 States; and in FY 2014 - The Consolidated Appropriations Act, 2014 (Public Law 113-76), which provided $20.419 million to only 26 States. It must be noted, the State High Risk Pool Grant Program officially ends on 09/30/2015. All States which received an award between FY 2012 and FY 2014 were federally qualified States currently receiving a HRP Grant award as a supplemental (extension) award to their 2008 Operational Losses.
- Beneficiary eligibility
State Agency.
- Credentials and documentation
Federal funds must go to a designated State Agency or its partner agencies. Individuals must meet State requirements.
- Uses of assistance
A State must have a qualified high-risk pool (as defined in section 2744(c)(2) of the Public Health Service Act) that has incurred a loss in order to be eligible for a grant.
- Length and time phasing of assistance
Under the original legislation, a total of $80,000,000 has been made available for the qualified high-risk pool operation grant program. $40,000,000 was made available for obligation from FY 2003-FY 2004 and another $40,000,000 was made available for obligation from FY 2004-FY 2005. Under the provisions of section 6202 of the Deficit reduction Act, $75,000,000 was made available in FY 2006 for this activity. The Consolidated Appropriations Act of 2008 made available $49,126,500. The Omnibus Appropriations Act of 2009 made available $75,000,000. The Consolidated Appropriations Act of 2010 made available $55,000,000. Sections 1119 and 1818 of the Full-Year Continuing Appropriations Act, 2011 authorized $54,890,000. The Consolidated Appropriations Act of 2012 made available $44,000,000.
How to apply
- Application procedure
The standard application form SF-424 and related forms, as furnished by CMS, must be used for this program. These forms may be downloaded from the following Web site, www.cms.hhs.gov/researchers/priorities/grants.asp. In addition to the standard forms some additional information regarding the history and description of the qualified high-risk pool, accounting of risk pool losses, and contact person information is also required. Please refer to the following Web site for additional information: www.cms.hhs.gov/HighriskPools. Applicants are required to submit an original and two copies of the application to the Gabriel Nah, Grants Management Specialist, (Gabriel.Nah@cms.hhs.gov)., Centers for Medicare and Medicaid Services (CMS, Office of Acquisition and Grants Management (OAGM) 200 Independence Ave., S.W., Room 739H, Washington, DC 20201
- Criteria for selecting proposals
Each application will be reviewed to ensure it meets the eligibility criteria (as stated above). If eligible, the State will be awarded the lesser 50 percent of losses incurred by its qualified risk pool for the fiscal year in question or its allotment under the formula for the grants.
- Award procedure
The Centers for Medicare and Medicaid Services (CMS) will make a decision for each application received. Each applicant will receive written notification of CMS's decision. Applicants approved for a grant award must submit a letter of acceptance to CMS within 30 days of the date of the award, agreeing to the terms and conditions of the award letter.
- Time to approval or disapproval
60 to 120 days.
- Appeals
If an application is disapproved, the reasons for disapproval will be fully stated.
Grant awards
Latest 10 of 45 listed here. See the rest on GovTribe.
Top recipients by federal obligations
| Rank | Recipient | Federal obligations | Share |
|---|---|---|---|
| 1 | Texas Health Insurance Risk Pool | $45,263,204 | 13% |
| 2 | Minnesota Comprehensive Health Association | $21,704,576 | 6% |
| 3 | Llinois Comprehensive Health Insurance Plan | $21,069,888 | 6% |
| 4 | Maryland Health Isurance Plan | $17,048,196 | 5% |
| 5 | Wisconsin Health Insurance Risk Sharing Plan Authority | $16,395,332 | 5% |
| 6 | Indiana Comprehensive Health Insurance Association | $11,773,026 | 4% |
| 7 | Washington State Health Insurance Pool | $10,943,895 | 3% |
| 8 | New Mexico Medical Insurance Pool | $10,941,526 | 3% |
| 9 | Department Of Consumer & Business Services | $10,029,082 | 3% |
| 10 | Missouri Health Insurance Pool | $9,693,255 | 3% |
10 of 37 recipients listed here. See the rest on GovTribe.
Federal obligations by fiscal year
| Fiscal year | Federal obligations |
|---|---|
| FY2016 | -$8,186,344 |
| FY2014 | $20,419,712 |
| FY2013 | $41,756,504 |
| FY2012 | $43,819,154 |
| FY2011 | $54,890,000 |
| FY2010 | $55,000,000 |
| FY2009 | $75,000,000 |
| FY2008 | $49,126,500 |
| FY2007 | $1,450,000 |
| FY2004 | $2,825,618 |
Quick answers
What is Assistance Listing 93.780?
Assistance Listing 93.780 is Grants to States for Operation of Qualified High-Risk Pools, a federal grant program run by Centers for Medicare and Medicaid Services (Department of Health and Human Services).
What is the CFDA number for Grants to States for Operation of Qualified High-Risk Pools?
Its CFDA number is 93.780: Assistance Listing numbers were called CFDA numbers before 2018.
How much funding has Assistance Listing 93.780 awarded?
45 grant awards under 93.780 have obligated $336,101,144 in federal funds to 37 recipients.
Who receives the most funding from 93.780?
The recipients obligated the most under Grants to States for Operation of Qualified High-Risk Pools are Texas Health Insurance Risk Pool ($45,263,204), Minnesota Comprehensive Health Association ($21,704,576) and Llinois Comprehensive Health Insurance Plan ($21,069,888).
On GovTribe
See this program's full record
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