President Joe Biden signed a package of health care-related executive orders in late January that, among other initiatives, will reopen HealthCare.gov for a special, three-month insurance enrollment period starting Monday, Feb. 15.
Nevadans will have the opportunity to sign up for insurance through the state-based Silver State Health Insurance Exchange and Nevada Health Link.
According to Heather Korbulic, director of the exchange, the open enrollment period will last through May 15.
The reason Nevadans will not be going through HealthCare.gov to obtain insurance is that the state made the decision to transition away from the federal platform in 2018 to both save money and gain access to relevant data concerning Nevadans signing up for insurance.
“I’m happy to say that, in 2020, Nevada Health Link became its own state-based exchange—which was actually really ideal timing, all things considered,” Korbulic said. “We’ve realized the autonomy, the flexibility, the cost savings and, really, the data we were looking for by making that transition.”
The exchange has already put this greater flexibility to use.
“We flexed on that flexibility this last year during COVID by opening an exceptional circumstance special enrollment period allowing almost 6,000 Nevadans in the months of March, April and then May of last year to get enrolled who wouldn’t have otherwise been able to—and that was in direct response to the pandemic,” Korbulic said. “We looked at healthcare.gov, and they were not opening those types of things.
Additionally the regular open enrollment period for plan year 2021, which began in November 2020, was extended by 30 days following a Nevada Health Link board decision. According to Korbulic, it resulted in greater numbers of Nevadans enrolling.
“We had nearly 82,000 Nevadans, up from the previous year—which was about 77,000. It was an increase of nearly 6%. That’s encouraging and kind of demonstrates the importance of having the exchange,” she said. “A lot has gone [on] for people over this last year in terms of losing jobs and just being in a situation of flux with their health insurance because of that. The Affordable Care Act is really designed to offer people affordability. So, should they leave a job or not have a job any longer, they will still have access to comprehensive and affordable insurance whether it’s through Medicaid or the exchange.”
Around four out of five Nevadans qualify for what’s known as “premium assistance,” subsidies that help cover the cost of insurance plans. Korbulic encourages people to not just peruse plan prices on the website. Instead, she said, people should sign up for an account and actually apply in order to see what subsidies may be available to them. Additionally, applicants who qualify for Medicaid will automatically have their applications forwarded to that agency from the state exchange.
Currently, people who make more than 400% of the designated federal poverty level do not qualify for subsidies, but Korbulic said this may change under the Biden administration.
“That cutoff really does create a cliff for people who are not eligible—because even if they make a dollar over that … they’re seeing dramatic increases in premium costs because they have to basically front the bill for the entire plan,” Korbulic said. “So, it can be prohibitively expensive. And we’re really looking forward to some of the actions the Biden Administration is taking to expand subsidy eligibility.”
“Making sure that people have access to comprehensive coverage is just critically important.”
Not only might the 400% poverty level cutoff for subsidies be raised, but the Biden administration may also push to increase the number of people who can opt out of employer offered insurance in favor of plans from the state exchange. Currently, only those whose employer offered plans meet or exceed 9.83% of their total earnings are eligible to do this. Soon, that percentage may be dropped to 8.5% of total earnings.
Korbulic said she is particularly encouraged by the communication that is coming out of the Biden administration and the people who have been placed in the U.S. Department of Health and Human Services.
“What we have experienced in the last four years is a real breakdown in communication where we would just get rule changes and notified of rule changes after they’d been done and really not having any kind of meaningful engagement that gave us time to build things or what have you,” she said. “Running a state-based exchange requires that we have a little bit of lead time so we can implement things successfully and help Nevadans get through things.”
Korbulic and her staff received several weeks’ notice of the plan to open a special enrollment period. While states with their own exchanges were not mandated to open an enrollment period, she said that in Nevada the idea was immediately embraced.
“Especially as it relates to this pandemic situation, making sure that people have access to comprehensive coverage is just critically important,” she said, adding that Nevada Health Link is well positioned and prepared for Monday’s reopening.
“Because we’ve been around the block and set up our own special enrollment period back in spring of last year, we just basically need to configure the rules and push go,” Korbulic said. “Our team at the exchange has spent the last few weeks testing and making sure that the system will act as it’s supposed to and that we will be equipped to take new enrollments.”
Korbulic said she can’t be certain if this new open enrollment period will yield numbers as high as the 6,000 people who signed up during the last one, but she is hopeful it may. And she’s hopeful that increasing the number of insured people will remain a priority throughout the coming years.
“I’m enthusiastic about seeing an administration that is leaning in and focusing on our collective goal, which is to get folks insured,” she said. “When we have an insured populace, we end up having not only improved public health and improved wellbeing for our constituency—but we also have a really good economic situation happening. It’s so important for people to have health insurance, to get that preventative care, to keep people actively vaccinated. … But, also, there is this downstream consequence of having a really robust economy.”