Nevada

First Oregon told Oracle to go pound sand after paying the company hundreds of millions of dollars for a useless website; now Nevada has officially done the same thing to Xerox:

The Silver State Health Insurance Exchange board voted unanimously Tuesday to end its relationship with Xerox, the vendor contracted in 2012 to build the exchange’s Nevada Health Link website.

In place of Xerox, the exchange will adopt the federal Healthcare.gov exchange’s eligibility and enrollment functions for the sign-up period that begins Nov. 15, though it will keep its status and funding as a state-controlled system. The exchange will also issue a request for proposals to evaluate replacement systems in coming years. A new platform could come from a state with a functional marketplace, or from a vendor with a similar, proven program.

Unlike Massachusetts, which is taking a dual-path approach (they're scrambling to replace their own crappy site with a new one while simultaneously preparing to move over to HC.gov just in case the first plan doesn't pan out in time), Nevada is sort of doing the opposite: They're moving over to HC.gov this year, but reserving the right to try a do-over on their own exchange for 2016 and beyond.

Minor update out of the only state whose ACA exchange is still officially open: QHPs up around 1,400, paid up around 200 since last week:

Update as of 5/10: 47,245 Nevadans confirm Qualified Health Plan selections. 35,034 have paid.

— Nevada Health Link (@NVHealthLink) May 14, 2014

Nevada is the only exchange still officially open for "normal" private QHP enrollments (although of course SHOP, Medicaid, etc. are all year-round). WIth this update, Nevada's paid QHP rate jumps from 71% up to 76% (still not great, but an impressive spike in one week...more the existing enrollees catching up with their payments than new ones being added):

The board overseeing Nevada Health Link was told Thursday that nearly 35,000 people had enrolled in a qualified health plan as of May 3, halfway through a two-month special enrollment period that ends May 30.

Another 11,000 have selected plans but not yet paid for them.

Managers believe they had QHP enrollment information and premium payments for 34,820 residents as of May 3.

Nevada is one of the few states extending their open enrollment beyond the "standard" 4/15 deadline; residents have until 5/30 to complete their enrollments for 2014:

Update as of 4/19: 45,291 Consumers have selected Qualified Health Plans, 32,365 have paid.

— Nevada Health Link (@NVHealthLink) April 22, 2014

Update as of 4/15: 44,468 consumers confirmed Qualified Health Plan selections through Nevada Health Link, 30,176 have paid.

— Nevada Health Link (@NVHealthLink) April 17, 2014

I think this is the first Nevada update I've posted which didn't come from the Nevada Health Link's Twitter feed. Technically only 28,208 have actually paid their first premium so far, but another 4,332 have scheduled their payment which is certainly a huge step ahead of having "enrolled but not even arranged for a payment" (and my model has 7% of this total being lopped out for potential non-payment anyway). So, 32,540 it is until further notice.

And the number of people who enrolled in and paid for a qualified health plan through the exchange hit 28,208 on April 5, up from 25,899 people on March 31. Another 4,332 consumers have scheduled payments.

Thanks to deaconblues for all three of these items:

Avalere Health, with whom I've both clashed and agreed with on ACA-enabled Medicaid enrollments in the past, is projecting as high as a net gain of 4.3M Medicaid enrollees through the end of March:

700K to 1.3M Additional Medicaid Enrollees through March, If Current Trends Continue.

However, March and April figures could bring more dramatic increases if outreach and enrollment efforts targeting the end of exchange open enrollment translate into new Medicaid enrollees. Specifically, if Medicaid sign-ups follow a similar pattern as exchanges, new Medicaid enrollees could reach 4.3 million by the end of March. In addition, recent figures released by CMS do not account for individuals assessed eligible for Medicaid through HealthCare.gov who have yet to be determined eligible by states.

Why the heck Nevada couldn't have posted the 3/31 total instead of tacking on 4/1, I have no idea, but what the hell; it's starting to look like I'll have to wait for the HHS report in order to get the precise monthly figure anyway (assuming they don't move the 30th & 31st over to April's report, that is...)

Update as of 4/1: 41,823 Nevadans confirm Qualified Health Plan Selections through http://t.co/k2YKIcssBl. 25,899 paid to date.

— Nevada Health Link (@NVHealthLink) April 3, 2014

OK, in addition to the appx. 7.041 million enrollments on the Federal exchange (HC.gov), I've brought CO, CT, DC, HI, KY, MD, MN, NY, RI and WA completely up to date, with all QHP data through midnight on 3/31 (some of the Medicaid/CHIP data is still missing, but that's a lesser concern at the moment).

However, I'm still missing the following exchange QHP data:

  • California: 22 hours (that's right...the current tally runs thru 2am on 3/31)
  • Massachusetts: 3 days (current is thru 3/28)
  • Nevada: 2 days (current is thru 3/29)
  • Oregon: 3 days (current is thru 3/28)
  • Vermont: 1 day (current is thru 3/30)

I can't tell you how frustrating it is to be this close to full data while still missing it.

So, how much is actually missing? Well, if these states were running at their prior average March daily rate, it would be

  • CA: 11,754
  • MA: 512 x 3 = 1,536
  • NV: 427 x 2 = 854
  • OR: 502 x 3 = 1,506
  • VT: 775
  • Total: 16,425

However, this obviously doesn't apply since the final weekend and especially yesterday were insane.

Nevada doesn't want to be left out of the craziness...OK, not exactly a major update but every one of those numbers is a human being (and one step closer to 7M)...about 4,500 more (although most of the new ones aren't paid yet...imagine that! They enrolled 2 days ago and still haven't paid? The horror!)

Update as of 3/29: A busy weekend for enrollment, 40,498 consumers confirmed Qualified Health Plan selections, 24,062 have paid. #GetCovered

— Nevada Health Link (@NVHealthLink) March 31, 2014

We are seeing record traffic counts at the call center and http://t.co/k2YKIcssBl. Many Nevadans are rushing to beat the deadline.

— Nevada Health Link (@NVHealthLink) March 31, 2014

A 1,000 increase in the number of paid exchange QHPs since 3/22:

Since Nevada Health Link opened, the state's exchange for insurance, there have been many problems in finishing the enrollment process.

More than 24,000 Nevadans have enrolled and paid, far lower than the projected estimates.

Meanwhile, Xerox (which botched the Nevada exchange just as Oracle botched Oregon's) thinks they'll be able to "convert" 57,000 of the partially-completed enrollments into full enrollees during the extension period (which actually runs all the way out until May 30th in Nevada's case...):

Xerox officials told the board that they’ve identified about 77,000 people they’ll target during special enrollment, which runs through May 30. Consumers eligible to sign up then include people who have selected an exchange plan but not paid for it, as well as people who qualified through the exchange for a federal premium subsidy but who have not bought a plan.

Company officials said they believe they could convert about 57,000 of the 77,000 targeted consumers into actual enrollees.

No exact numbers, but the previous update as of 3/15 was 22,533 paid / 10,520 unpaid (33,053 total), so this looks right. NV's March pace is still running around 45% above February's daily average.

As of March 22, more than 35,000 people have signed up for a health insurance plan. Approximately 23,000 of them have already started making payments on their health care coverage.

OK, this is a tiny number but every data point helps...in an article about the final crunch-time outreach efforts is this bit about the Nevada Health CO-OP's success:

The CO-OP sells plans both on and off of the exchange, but the “vast majority” of consumers who ask about plans are subsidy-eligible and buying on the exchange, Egan said. The CO-OP has actually sold more plans through the exchange than any other insurer: It’s responsible for 37 percent of plans sold, beating out industry titans UnitedHealthcare and Anthem, the state’s two biggest insurers. The CO-OP had sold about 9,500 plans on the exchange and just under 1,000 off of it as of Tuesday.

I'm gonna call "just under 1,000" 990 (shrug).

OK, the cutesy title is kind of a misnomer; my two previous entries didn't use that title originally...but they should have, and do now.

March 31st is supposed to be the final day to enroll in QHPs via the exchanges...but it's looking more and more as though that won't quite be the case in not two, not three...but possibly up to seven states now, including a couple whose websites have been working smooth as silk??

On March 7th I pointed out that due to Massachusetts having some 154,000 people stuck in health insurance limbo, they've been granted some sort of temporary extension, twice...out to as far as June 30th in some cases...

On top of today's Big News out of California (1M) and the HHS (5M) comes a smaller, but just as significant update from Nevada. They're up from 20,930 paid / 9,085 unpaid (30,015 total) to 22,533 paid / 10,520 unpaid (33,053 total), a total increase of 3,038 (although the Paid rate in NV is down slightly, from 70% to 68%...although again, none of the new enrollees start coverage until April).

The significance is this: The first week of March, Nevada was averaging 211 QHPs/day, virtually identical to February's 212/day. However, with this addition, their daily average has shot up to 323/day, a 52% increase. Even more impressive, if you only include the 2nd week of the month, that's 3,038/7 = 434/day, or more than twice the daily average. The Surge is definitely here, folks.

Update as of 3/15: 33,053 consumers have confirmed Qualified Health Plan selections through Nevada Health Link, 22,533 have paid.

— Nevada Health Link (@NVHealthLink) March 17, 2014

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