Nevadans Facing Friday ACA Sign-Up Deadline

Nevadans have until Friday to enroll in a health insurance plan through the Affordable Care Act exchange after federal officials denied a request to extend the state’s sign-up period.

Heather Korbulic, executive director of the Nevada Silver State Health Insurance Exchange, wrote to the federal Centers for Medicare and Medicaid Services in October, before the open-enrollment period began, requesting the extension.

“I asked if Nevada, being a state-based marketplace using the federal platform, would have flexibility,” Korbulic said Tuesday, referring to the fact that the state exchange runs on the federal Healthcare.gov platform.

Officials at the Centers for Medicare and Medicaid Services rejected the request about a month later, sticking to the decision to cut this year’s open-enrollment period in half — from 90 days to 45 — and end it on Dec. 15.

In seeking the extension, Korbulic also noted that Healthcare.gov planned to shut down for 12, six-hour maintenance periods, lasting from 9 p.m. Saturday through 9 a.m. Sunday, every weekend until Dec. 3, which she said was a hardship for many Nevadans.

“A large component of Nevada’s largely urban private sector operates 24 hours,” Korbulic wrote in her letter. “Our estimation is that cutting out any time slots, whatever time of day, from the already shortened open enrollment period will have an impact on Nevada’s efforts to even maintain current levels of enrollment.

In denying the extension request, CMS Deputy Administrator Randy Pate stated the shortened enrollment period would lower prices by encouraging the healthy to sign up for full-year coverage and minimizing last-minute enrollment among those who fall ill, both of which can stabilize the market.

Premiums did in fact fall for those who bought plans with subsidies after insurers responded to President Donald Trump’s decisions to eliminate subsidies called cost-sharing reductions. They rose, however, for those paying full price.

He also said scheduled maintenance downtime compared favorably to the previous year.

“Last year, while unannounced,” the letter read, “Healthcare.gov was down for 53.5 hours out of a planned 54 hours during the first six Sundays of open enrollment.”

“As the director of the exchange, I have sought an explanation for such measures,” Korbulic wrote, in reference to scheduled site outages and the shortened enrollment period, “but have not received a satisfactory answer from CMS, nor is there an obvious reason for the changes.”

Nevada is one of 39 states which uses Healthcare.gov to sell insurance plans under the Affordable Care Act. It transitioned to the federal platform in 2015 after efforts to offer plans on its own website were disrupted by technical difficulties.

As such, Nevada has less flexibility in enrolling consumers than other states with at-home exchanges, like California. Through Covered California, the state’s residents can enroll in an Affordable Care Act plan until Jan. 31.

About 85,000 Nevadans enrolled in an exchange plan last year, about 85 percent of whom received federal subsidies to help cover the cost of insurance. While its weekly enrollment numbers this year have so far surpassed weekly numbers from 2016, only 35,000 had enrolled as of Dec. 2 due to the shorter enrollment period.

Though that number will increase after open enrollment closes with the automatic re-enrollment of those who are up-to-date on payments for their exchange plans, Korbulic said she doesn’t expect to match last year’s total. Those who don’t sign up for a plan could be subject to fines for being uninsured.

But those waiting until the last minute to purchase plans could be courting trouble, say health insurance brokers who expect the Healthcare.gov platform to crash or experience glitches as late sign-ups surge.

“The website always crashes the last two days,” said Willy Lipat, a broker who works out of his Las Vegas home. “This year is going to be the same.”