The number of Nevadans who enrolled in plans through the state’s health insurance exchange during this year’s open enrollment period fell by about 7,300 over last year’s totals, according to preliminary data released by the Centers for Medicare and Medicaid Services Wednesday.
The Silver State Health Insurance Exchange enrolled 83,647 people in plans during the 45-day open enrollment period, which ran from Nov. 1 to Dec. 15, a drop from the 90,962 people it signed up over the same time period last year. The preliminary total does not include people who enrolled in coverage in the early morning hours of Dec. 16 or those who left their contact information with the call center for a call back due to high call volume. Final totals are expected next week.
Enrollment in exchange plans has been down over the course of the open enrollment period amid additional challenges this year including the expansion of health plans with skimpier coverage, telemarketing scams, misinformation about a new federal rule change and the repeal of a health insurance mandate penalty. The gap between last year’s numbers and this year’s decreased week over week, from a 37.5 percent shortfall at the beginning of open enrollment to 8 percent by the end.
Heather Korbulic, the exchange’s executive director, said Wednesday afternoon that she was “disappointed” in not only the numbers but what they mean for the thousands of Nevadans who are either choosing to forego health insurance this year or purchase plans that are not as comprehensive as plans that comply with the Affordable Care Act, or ACA.
“I’m disappointed because I know how hard we worked and how much energy our stakeholders and our enrollment partners put into this. But ultimately what this tells us is even with an eight percent decrease we’re still helping tens of thousands of Nevadans and the ACA remains relatively resilient all things considered,” Korbulic said. “People still need access to the subsidies to access affordable and comprehensive plans. The exchange is going to remain committed to making sure that happens.”
Overall enrollment was also down this year, with 8.5 million people enrolling this year compared to 8.8 million in 2017. Those totals do not include enrollments in state-based exchanges that do not use the federal HealthCare.gov platform, such as Covered California.
The exchange, a state-based marketplace operating on the federal platform, will have more control over open enrollment when it transitions to a state-run platform before next year’s open enrollment begins on Nov. 1, 2019. Fully state-based marketplaces can extend their open enrollment periods and also have full control over their data, meaning an increased ability to recruit and retain customers.
“When you take a look across the country states that are on HealthCare.gov are for the most part down and states that have their own state-based exchanges are for the most part up. I think that this really emphasizes and highlights that need to become a state-based exchange because we have access to our consumers,” Korbulic said. “Nevadans know how to help Nevadans the best.”
Korbulic has pointed to the expansion of two types of health insurance plans that aren’t required to provide the same level of benefits as ACA-compliant plans — short-term limited duration plans and association health plans — as one possible reason for lower enrollment this year.
Other factors affecting open enrollment this year included Congress’s repeal of the tax penalty associated with the ACA’s individual mandate, an improving job market, less attention on the federal health-care law this year than during the repeal-and-replace attempts last year, and a proposed federal rule that may have had a chilling effect on immigrants afraid to take federal subsidies to pay for health insurance on the exchange.