Sandoval: Exchange options limited
May 5, 2014
There are no good choices for Nevada as it tries to decide what do to about its troubled health insurance exchange, Gov. Brian Sandoval said.
In a previously taped television interview that aired Monday, the Republican governor said he's frustrated by the position Nevada finds itself because of a botched online system developed by Xerox. But fixing it in time for the next open enrollment period that begins in November brings additional challenges and is complicated by a state law that mandates Nevada will operate its own exchange.
"None of these are good choices, and I'm very frustrated because we've been put in this position," Sandoval said on KRNV-TV's "Nevada Newsmakers."
It's "kind of a fatal outcome wherever you go, in terms of it's going to be a difficult road as you move ahead," he said.
Xerox was awarded a $75 million contract to build and operate the exchange called Nevada Health Link, though it's only received about $12 million of the total because of lingering problems that stymied it from the start.
Because of persistent computer and billing errors, the board overseeing the exchange approved a special enrollment period through May 30 for the thousands of people who tried to sign up before the March 31 deadline but were thwarted by the system.
As of mid-April, about 45,000 people had selected plans and 32,000 had paid for premiums — far fewer than the original 118,000 projected.
In March, Nevada approved a $1.5 million contract for Deloitte Consulting, a Xerox competitor, to evaluate the Xerox system and ways to make it functional for the next open enrollment period this fall. Deloitte presented a 90-day report last week, and exchange staff is now crunching numbers to determine cost and feasibility of three options referenced.
Sandoval said the choices come down to keeping Xerox; keeping Xerox and oversight by Deloitte; soliciting proposals to adopt systems successfully launched in other states; or scrapping the state-run program and joining the federal exchange, like Oregon officials decided to do last week.
But that last option has its own complications, Sandoval said.
"We can't automatically go to a federal exchange," he said, noting a state law mandates Nevada operate its own. That would require approval by the Legislature, which doesn't convene until February 2015 — some 2½ weeks after the next open enrollment period ends.
Despite problems, Sandoval said there is a positive to the exchange and federal health care reform. Though signups for private insurance have lagged, Nevada's Medicaid enrollments have soared.
Sandoval, who was the first Republican governor to accept Medicaid expansion under the law, said about 150,000 new people are now covered through managed care plans under Medicaid.
"We're very confident Nevada's going to go from 23 percent uninsured, which was the second worst in the country, to the single digits in about a year and half," he said.
"So there is a good story to tell."