Board member calls Nevada health exchange ‘full failure’; agency working on fixes

By SANDRA CHEREB

Associated Press

CARSON CITY, Nev. (AP) — Overseers of Nevada’s health insurance exchange said Thursday that staffers should be working on alternative plans for the problem-plagued online portal, with one board member calling the system a “full failure.”

The comments from members of the Silver State Health Insurance Exchange came after hearing consumers’ continued complaints about long wait times and unresponsive support from Xerox, operator of the website called Nevada Health Link. The system was more than two years in the making.

Claudia Lamb detailed the frustrating experience she and her husband went through after first trying to apply in early October when the system went live.

“We have had two applications accepted and then rescinded without notice,” she said. Lamb said she spent more than 100 hours on the phone and several hundred more waiting for return phone calls that never came.

For months, she said, no one could tell them why her husband’s application was continually rejected. They finally found out on Jan. 15.

“All this time Xerox had classified my squeaky clean, never-been-arrested husband as an incarcerated felon,” she said.

It was only on Wednesday, 129 days after they first applied, that they were able to confirm coverage.

“I think this is a full failure,” vice chairwoman of the board Lynn Etkins said after listening to consumer gripes and a report from executive director Jon Hager.

The exchange on Wednesday lowered its projected target enrollment to 50,000 by March 31, down from 118,000 initially projected, but even meeting the new goal will be a challenge, Hager said.

As of last week, roughly 24,000 people had selected plans through the exchange. Given those statistics, the exchange will have to sign up as many people in the next six weeks as it did in the past four months to reach the target enrollment.

“We don’t just get to move the goal posts,” Etkins said. “We are a governing board and we have a much broader responsibility than to just listen. What is our Plan B?

“I have no confidence in Xerox,” she said.

In his report, Hager conceded January “has been a difficult month.”

“We have had website problems, long wait times at the call center, frustrated partners, frustrated consumers and low enrollment.”

Hager outlined immediate goals that reflect issues that have plagued the system from the start: Fix the website and fix the call center.

Xerox has been under fire for computer glitches and woefully underestimating staff needed at a call center to assist consumers by phone.

Hager said the company in December tripled the number of developers working the project and last month added management and business analyst resources, resulting in faster corrections when problems arise.

Additionally, as of last week, call center staff has increased to 183, with another 66 undergoing training. The center also has expanded its operating hours to 6 a.m. to 11:30 p.m. weekdays and 8 a.m. to 4:30 p.m. weekends.

Wait times have been trimmed to less than 30 minutes in most cases, he said, a big improvement from more than an hour in January.

Marie Kerr, another board member, noted ongoing problems with billing and coverage verification.

“How are you supposed to run a business that way?” she said. “What’s going to happen to people who’ve incurred medical expenses?”

Hager said bringing in a new operator for the website would be neither quick nor easy.

“At this point the option is to fix the problem that we have,” he said.

While sign-ups for private insurance have been slow, the number of people signing up for Medicaid has surged.

Three times as many people seeking health coverage through the exchange have signed up for government-backed Medicaid or another insurance program for low-income children than have purchased private coverage — 69,000 versus 23,000. Those numbers don’t include people who signed up for Medicaid through the state Division of Welfare and Supportive Services.

In January, Nevada’s Medicaid caseload grew by 36,000 to 377,363, according to the Department of Health and Human Services. Since the start of the year, more than 50,000 Medicaid applications have been referred through Nevada Health Link alone.

As of Wednesday, the agency had a backlog of 57,000 applications awaiting process.