HCR Update from Mark Sanna: HHS has awarded eight states more than $765 million in additional grant funding to establish the health insurance exchanges. HHS awarded level-one establishment grants—which provide a year of funding to states that have already started the process to build an exchange—to California, Hawaii, Iowa and New York. Meanwhile, Connecticut, Maryland, Nevada and Vermont received level-two grants, which are awarded to states that have made more progress in their planning efforts.