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Wednesday, October 22, 2014         

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Nevada to switch to federal exchange

Xerox is blamed for the state's problematic online health insurance system

By New York Times

POSTED:



WASHINGTON » The board of Nevada's problem-plagued online health insurance exchange voted Tuesday to end its contract with the vendor in charge of building it and rely on the federal enrollment system for at least a year.

The board voted unanimously to sever ties with Xerox, which had a $72 million contract to build the Nevada exchange and has been paid $12 million to date. The exchange has been riddled with problems, including billing and enrollment errors that led to a class-action lawsuit by 200 customers who said they paid for exchange plans but still have no coverage.

Roughly 46,000 people had signed up for private coverage through the exchange as of May 10 — far fewer than the original enrollment target of 118,000.

(Hawaii's troubled health insurance exchange is still trying to get embattled contractor CGI Group Inc. to fix software defects before the next open enrollment in November. Hawaii Health Connector officials said CGI is three months behind schedule in delivering operational functionality to the exchange.

"The issues are still significant," Anjali Kata­ria, the Connector's chief information officer, told board members at a meeting last week. "CGI is still delivering functionality that was due at the end of March. The Connector is working aggressively with leadership of CGI to ensure the dates CGI is promising will be met.")

Nevada is joining a string of other states that have scrapped their exchange contractor and switched course after determining there were too many problems to fix in time for the next enrollment period, which starts Nov. 15. Oregon scrapped its botched exchange website last month after spending $248 million on it, and will use the federal exchange instead. Maryland, too, is abandoning its exchange, but is turning to software developed for Connecticut's successful exchange.

Massachusetts decided this month that its exchange website was unusable and that it would buy an off-the-shelf system instead, while also holding open the possibility of joining the federal exchange for a year if the new system is not ready in time for the next enrollment period. Preparing for both options will cost an estimated $121 million, on top of tens of millions already spent on the broken exchange.

Nevada's governor, Brian Sandoval, is one of the few Republican governors who embraced both a state-based exchange and an expansion of Medicaid under President Barack Obama's Affordable Care Act. He remains a popular leader in his increasingly Demo­cratic state, which has seen much more success with people signing up for Medicaid under the law.

About 190,000 have been found eligible for the program so far through the exchange, according to Xerox.

A spokesman for Sandoval, who is considered a potential Republican vice presidential choice for 2016, said Xerox had "failed to perform its contractual duties," adding, "The board made the best decision it could under these difficult circumstances."

Instead of fully joining the federal exchange that serves more than 30 states, a step that would require legislative action, Nevada's exchange board voted to use the federal eligibility and enrollment systems for the next sign-up period while keeping its autonomy as a state-based exchange. Applicants will still go through www.nevadahealthlink.com, but the federal government would do the back-end enrollment work, said Steve Fisher, the exchange's interim executive director.

The board will also consider adopting another state's successful exchange system, as Maryland is doing. But that system would not be in place until the 2015-16 enrollment period and would likely cost tens of millions of additional dollars.

A spokeswoman for Xerox called the vote "extremely disappointing" and pointed to the exchange's success at enrolling Nevadans in Medicaid.

———

Star-Advertiser report Kristen Consillio contributed to this story.






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