The Silver State Health Insurance Exchange board approved its annual report to the governor and Legislature on Thursday, emphasizing the importance of moving from the federal healthcare platform to a state-operated exchange.
“As the exchange examines the dynamic future of the ACA landscape, it becomes more and more evident that state-based control will be key to providing trustworthy services to Nevadans,” the summary states. “Although the federal landscape remains divided in partisanship, the exchange is confident that its self-funded direction will continue to provide quality resources and services at the lowest cost point available.”
A key issue the exchange is monitoring is the recent Texas federal court decision ruling the Affordable Care Act unconstitutional. If that decision stands, the report says, as many as 130 million Americans with pre-existing conditions could face exclusions, premium increases and denials of coverage.
According to the report, an estimated 25 percent of Nevadans under age 65 have pre-existing conditions.
A growing number of states are united in challenging that federal court ruling and, on Thursday, Attorney General-elect Aaron Ford said Nevada would join that list of states in opposing the Texas decision.
To make the switch to a state-based rather than federal-supported exchange, SSHIX officials in August signed a contract for a technology platform and consumer assistance center designed to ensure the state system remains solvent by greatly reducing the cost of federal ACA administration. The state based exchange is projected to go live by Nov. 1, 2019 and to save the state a projected $18.9 million through fiscal 2023 by avoiding the rapidly rising premium assessments the federal HealthCare.gov exchange is charging.
To handle the load, the exchange’s proposed budget asks for an additional 11 full-time employees, raising total staffing to 24 people.
“Additional staff will increase operational costs in the personnel budget category, however, the combined savings realized on technology, consumer assistance and additional staff will still demonstrate a savings of nearly half of that which would have been spent on HealthCare.gov,” according to the report.
The proposed budget calls for a total of $21.4 million in fiscal 2020 but just $13.1 million in 2021 because of the shift to the state-based exchange. Those amounts aren’t out of the state General Fund but generated by the 3.15 percent premium fee on the gross monthly premiums collected from insurance carriers.
The report will be forwarded to the Legislature and the governor’s office for review.