Several Nevada Republicans are trying to scrap the Silver State Health Insurance Exchange launched as part of President Barack Obama’s health care overhaul, saying the program is expensive, suffered a rocky start and is another example of federal overreach.
The Senate Commerce, Labor and Energy Committee held a hearing Monday to review SJR14, which is sponsored by Sen. Don Gustavson and proposes an amendment to the Nevada constitution to ban insurance exchanges. An Assembly committee held a hearing later in the day to discuss AB368, a measure sponsored by Assemblyman Brent Jones that also seeks to abolish the exchange, but through statute as opposed to the constitution.
“Why continue to spend money on things that are inefficient?” Jones said, noting that only about 1 percent of the state’s population signed up in the first round of enrollment.
Critics pointed to the major technical problems in the first few months of the program that prompted the state to prematurely cancel its $75 million agreement with contractor Xerox last year. Nevada then shifted from a state-run exchange to a federally supported exchange that uses the technical infrastructure of the federal HealthCare.Gov website, while the state is responsible for promoting the program to Nevadans and offering enrollment assistance.
Jones argued that with the shift, the state’s involvement is duplicative.
“We’re trying to get the state out of the business of what the federal government is already doing,” he said.
Others countered that the state exchange is hitting its stride. Nearly 74,000 Nevadans had purchased an insurance plan through the federal marketplace by end of the enrollment period that wrapped up in February — double the number that enrolled in the first go-round.
“While the Silver State Health Insurance Exchange’s problems in 2014 are well documented, we believe that 2015 has shown that a state-based exchange … can be and is successful,” said Keith Lee, a lobbyist representing the Nevada Association of Health Plans.
Witnesses who testified against the exchange, including former Republican assemblywoman and Senate candidate Sharron Angle, say premiums have increased since the health care law was enacted. They also say the system is, at its core, a federal initiative that steps on states’ rights, and raised concerns that it could someday become the only place people can buy insurance.
“It is important to see each and every state exchange as simply a state-funded part of what is actually a national exchange under federal control,” said Twila Brase, president and co-founder of Citizens’ Council for Health Freedom.
Bruce Gilbert, executive director of the exchange, defended the program. He noted that a Nevada constitutional amendment would not repeal the overall Affordable Care Act, and would simply turn administration of the health plans over to the federal government.
He said that would be more expensive for Nevada consumers due to higher fees charged by administrators of the federal marketplace.
Proponents also argued that state involvement in the exchange allows Nevada officials control over the policies offered there, and they praised the model’s Nevada-specific marketing.
“Creating a state exchange gives us the best opportunity to promote insurance directly to Nevadans without coverage,” said Elisa Cafferata, president and CEO of Nevada Advocates for Planned Parenthood Affiliates.