Open enrollment for health plans through the Affordable Care Act will have a slightly different feel this year in Nevada. Namely, a break from the federal exchange.
This is the first year Nevada Health Link — the state’s online health insurance marketplace insurance marketplace — is operating as a state-based exchange rather than through healthcare.gov, the federally run exchange. The open enrollment period is Nov. 1 through Dec. 15.
The transfer will save more than $4 million in fiscal year 2020 and allow the state full access to data used for marketing and advertising, according to the Nevada Health Link.
“This has been a long time in the making and a really complex project, but so far so good,” said Heather Korbulic, executive director of the Silver State Health Insurance Exchange, which oversees Nevada Health Link.
Reports published earlier this year from Covered California, Massachusetts Health Connector and Washington Health Plan Finder — three state-operated exchanges — saw both lower premiums and smaller drops in enrollment in their programs than the federally run program. Korbulic said the $4 million in savings is from the money used to lease healthcare.gov.
“It started with the expense to lease healthcare.gov,” she said. “Basically, the rent to lease those services — the eligibility and enrollment platform on healthcare.gov — has increased year over year. That has put us in a position where almost the entirety of our revenue that we generate to support the operations of our exchange (is) going toward leasing the healthcare.gov system.”
Korbulic said the lack of comprehensive data on who was enrolling in the exchange hurt their ability to do things like enrollment marketing.
“It hindered our ability to do a good job in advertising and marketing, where we could spend dollars differently on recruitment efforts, meaning trying to gather new, uninsured folks to get insured through the exchange, versus retainment and keeping those folks who are already on the exchange,” she said.
A state-based exchange, she said, can also offer the ability to implement new policies the federal exchange doesn’t, such as an extended enrollment period, which could be a possibility in Nevada in future years, Korbulic said. One change that she said will be rolled out the first year is the consumer's ability to buy a dental plan without a qualified health plan, which is not possible on the federal exchange.
There are three different carriers on the state-based exchange — Health Plan of Nevada, Silver Summit and Anthem — with 27 different plans among them. There are also six dental carriers and 17 stand-alone dental plans. The plans vary by location.
“The counties of Clark, Nye and Washoe will have the ability to choose between all 27 plans, and then every other county will have 17 different plans between Anthem and Silver Summit,” she said.
Residents can already begin searching for their plan. “Window shopping” opened last week, allowing consumers to enter their information to look at available plans.
Korbulic warned that plans outside of the marketplace may not be as comprehensive as people assume. Qualified health plans with the exchange include 10 benefits: ambulatory patient services, emergency services, hospitalization, pregnancy, maternity and newborn care, mental health and substance abuse, prescription drugs, rehabilitative and rehabilitative services and devices, lab services, preventive and wellness services and chronic disease management and pediatric services including oral and vision care. They also cannot discriminate based on preexisting conditions.
“Somebody may be telling you that you’re going to buy a comprehensive health plan, but you really want to make sure that … they’re not raiding your plan based on your existing health conditions and that you’re getting all of those 10 essential health benefits,” she said. “Because if you’re not, you’re paying for what you get. You’re getting a skimpy plan that isn’t going to cover all your medical needs and may leave you high and dry with huge medical expenses.”
Korbulic cited a Guinn Center for Policy Priorities report that Nevada has around 400,000 uninsured people, with 100,000 of them “potentially eligible” for the exchange or subsidies on the exchange. According to the Kaiser Family Foundation, in the last open enrollment period, around 83,500 Nevadans signed up on the exchange. Nationally in that same period, over 11,444,000 people bought plans on the marketplace.
“The testament to the strength of the Affordable Care Act is the number of Nevadans who are still connecting and still getting affordable qualified health plans on Nevada Health Link,” she said. “If here wasn’t a demand and a need, then the exchange might not have nearly as many consumers.”