The Department of Health and Human Services plans to award five early grants to state governments or coalitions of states that have ambitious but achievable proposals to build state health insurance exchanges that can be used as models by other states.

HHS is not disclosing the size of the grants, but they are tied to a provision of the Accountable Care Act that authorizes $51 million for grants of up to $1 million to the 50 states and District of Columbia. The competitive process announced on Oct. 29 for five early grants, called the "Early Innovators" program, will not preclude the grantees from receiving future funding to support ongoing exchange implementation.

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