Nevada: NEW state-based exchange website now live!

Way back in October 2013, the very first official ACA Open Enrollment Period began...and was an immediate disaster for not just the federal exchange website (HealthCare.Gov), but also for about half of the states which were operating their own whole-widget ACA exchange websites.

That first year, there were 15 states doing so: California, Colorado, Connecticut, the District of Columbia (not actually a state, I know), Hawaii, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New York, Oregon, Rhode Island, Vermont and Washington State. There were oddball problems at launch with most of them, but HI, MD, MA, MN, NV, OR and VT had serious issues.

Minnesota and Vermont managed to work the bugs out of their systems themselves over the next couple of years. Maryland and Massachusetts ended up having to scrap their original tech platforms, but worked quickly to replace them with brand-new platforms quickly enough to never miss a beat, and have performed smoothly ever since. Hawaii's system was so screwed up--not just their tech platform but their entire exchange management team--that they ended up pulling the plug on the exchange entirely in 2015.

And then there's Nevada and Oregon. Both states also had disastrous exchange launches in 2013 to the point they had to scrap them after the first Open Enrollment Period ended. Oregon famously (or infamously) sued their developer, Oracle; Nevada's messy system had been developed by Xerox, and both states have turned to HealthCare.Gov to handle the actual enrollment process for them ever since.

However, unlike Hawaii, neither state's actual exchange entity was dissolved. Both still have a board of directors, their marketing budgets, their own plan design authority and so forth; they've simply been outsourcing the actual enrollment process itself to the federal exchange for the past five years. Instead of being either "FFM" states (Federally-Facilitated Marketplace) as most states are, or "SBM" states (State-based Marketplaces), as states like California and New York are, Oregon and Nevada changed their status to something in between: "FF-SBM" states (Federally-facilitated State-based Marketplaces").

There were actually three other states in this category at one point: Arkansas, Idaho and New Mexico. All three were planning on splitting off onto their own full exchange platforms after the first year or two, but as of today, Idaho is the only one of the three which has done so.

Arkansas technically "operates" their own exchange via HealthCare.Gov, but you'd never know it from the evidence...and in fact earlier this year, the state actually sort of pulled the plug officially by dissolving their exchange board, although I think AR is still technically classified as a FF-SBM.

Meanwhile, Kentucky, which had operated their own "kynect" ACA exchange quite successfully and without complaint for three years, had it scrapped in early 2016 by newly-elected GOP Governor Matt Bevin particular reason other than spite, really.

After the dust settled on all of this, there have been a total of five FF-SBM states for the past few years: Arkansas, Kentucky, New Mexico, Nevada and Oregon.

In June 2015, right after the infamous King vs. Burwell Supreme Court decision was announced, I made what seemed like a farfetched prediction:

It's even conceivable--unlikely, but conceivable--that a few years from now, after 1) The ACA has become even more firmly entrenched nationally; 2) the software/technology for running a state exchange has become even more streamlined, simplified, faster, easier to use, cheaper, etc etc; and 3) (hopefully) some changed attitudes/changed administration officials (ahem), a few states on now may even decide to go ahead and move onto their own "full" exchange/website after all...completely of their own volition.

I realize that sounds pretty crazy now (since there'd be no financial incentive to do so), but anything's possible...and with King out of the way, at least that's a viable option now.

Eighteen months ago, in February 2018, I noted that Nevada had decided that, sure enough, it was time to give complete control over their exchange another shot:

Nevada wants out of federal health exchange

Nevada's Silver State Health Insurance Exchange took the first step on Thursday to getting out of the federal system and build its own exchange.

The Legislative Interim Finance Committee granted SSHIX $1 million from its own reserves to put together an RFP and find a private provider.

...Heather Korbulic, executive director of the Nevada exchange, said they have to make a change because the federal exchange is raising its premium rates dramatically.

...She said when the federal charge rises to 3 percent in 2019, it will consume all but a tiny fraction of the 3.15 percent premium leaving the state almost nothing to run the front-end operation.

Since that announcement, the dominos have started to fall in other states: New Mexico, New Jersey, Oregon, Pennsylvania, and just last week, Maine have all made similar announcements, although none of them will be ready to go live with their own websites until next year or the year after that (also, Oregon is still in the "consideration" stages with an RFP, last I heard; this is the third time they've done so, so who knows if they'll follow through or not?).

This brings me back to today's news out of Nevada: After a year and a half of planning and preparation, the all-new Nevada Health Link ACA exchange website has (soft) launched ahead of the 2020 Open Enrollment Period:

Nevada Health Link’s new call center, website now live

The Silver State Health Insurance Exchange, Nevada’s state agency that helps individuals obtain budget-appropriate health coverage through the online marketplace, Nevada Health Link, announces that starting Wednesday, consumers who previously purchased qualified health plans on can claim their migrated accounts on Nevada’s new state-based website, Nevada Health Link.

This is the first step enrollees should take to ensure their account is ready for open enrollment beginning on Nov. 1, 2019.

Previously enrolled Nevada consumers can expect to receive an email inviting them to claim their account; once the account is claimed enrollees will have the opportunity to update their preferences to be automatically renewed in a plan or to designate a broker to assist with enrollment.

Consumers should know that they can also preview plans and prices starting October 3, 2019. The opportunity to actually enroll in a qualified health plan will not begin until November 1, 2019. Enrollment closes at midnight on December 15, 2019.

Those who need additional assistance can call the call center directly at Nevada Health Link's new customer service line: 1-800-547-2927.

A huge shout-out to Heather Korbulic, the executive director of the NV exchange, for the hard work she and her team have put into making this happen. I look forward to changing Nevada's exchange status on my spreadsheets from white to blue, joining 12 other states in control of their own ACA destiny going forward.