Consumers shopping as Nevada health insurance exchange opens

It’s a good thing you have until Dec. 15 to sign up for health coverage under the Affordable Care Act.

Insurance exchanges across the country, including in Nevada, struggled Tuesday with first-day technical issues that made it hard for people to enroll online.

Jon Hager, executive director of the Silver State Health Insurance Exchange, said the kinks weren’t completely unexpected.

“This is the largest (information technology) mobilization in history. It’s not all roses, and there’s still a long way to go,” Hager said. “People who shop today will have a much different experience than people who shop in a month or two. There’ll be hiccups, errors and other bugs. There are gremlins in any big project, and this project is as big as it gets.”

Those bugs didn’t shut down the exchange altogether, though. Officials said Nevadans had created 3,385 accounts through www.nevadahealthlink.com and had received 1,536 phone calls into its call center by 4 p.m. The site recorded 77,000 page views by 36,000 unique visitors by 5 p.m., and had 99 applications in process by 5:45 p.m. It was set to close for the night at 8 p.m.

Insurers offered varying reports of first-day activity.

Nevada Health CO-OP, a nonprofit insurer created to sell plans on the exchange, said it got more than 100 calls and more than 300 website hits from 8 a.m. to noon. Web visitors came from 20 Nevada cities, as well as from China, India and Germany.

Anthem, Nevada’s second-biggest insurer, said it was too early to comment on call volume. The largest carrier, UnitedHealth Group, didn’t have a count.

It wasn’t an easy day for some people looking to buy new plans.

The marketplace reported its first glitch shortly after 8 a.m., when it said its site was down because it had just reloaded plan information into the system. Everything was up and running at 8:20, but by noon consumers were reporting other problems.

Several readers told the Review-Journal they kept getting error messages while answering security questions in trying to sign up for an account. A Review-Journal reporter also got error messages while registering mid-day, but was able to look at plans and premiums without starting an account.

One reader who called the exchange said a customer-service rep told him it would be one to two days before the kinks are fixed.

Exchange spokesman CJ Bawden said high traffic caused some problems early in the day. He acknowledged problems with creating accounts, but said the issues were intermittent and seemed to be based on technical details such as browser problems. He said IT staffers would work on the site through the evening to fix it.

The federal system, which most states use, also had issues as a crush of consumers tried to sign up.

Hager predicted that pattern last week, when he told the Review-Journal he expected a surge of interest on the first day thanks to early adopters who’ve been waiting for the exchange. But he also said he anticipates interest to wane shortly after the marketplace’s opening, and pick back up closer to late November, as the Dec. 15 coverage deadline approaches.

Tuesday’s glitches weren’t confined to technical website problems.

The exchange’s Spanish-language portal wasn’t ready, and won’t be until mid-November. The delay makes it tougher to enroll online for many of the state’s uninsured: Nearly half of Nevadans who lack coverage are Spanish speakers.

Hager said Spanish speakers could still sign up by calling 855-768-5465. Consumers who want face-to-face help can enter their ZIP code at the exchange’s website and get a list of licensed insurance brokers and navigators who can help them enroll.

Also missing Tuesday was the website’s out-of-pocket cost calculator, which helps consumers figure how much they’d owe in co-pays before they buy a plan. Nor could shoppers use the intent-to-reside function, a tool that determines eligibility for people who are moving to Nevada soon but who haven’t yet relocated. And a tool to prove financial hardship for the purchase of a catastrophic plan wasn’t live, either.

Hager said the functions should be available by mid-October.

Some consumers who checked quotes through the exchange reported sticker shock.

Tim Plaehn, a 50-something writer from Gardnerville, wrote the Review-Journal to say the rates he and his wife were quoted for an individual plan are “about triple” what insurers have quoted him directly.

Officials have said premium changes won’t jump across the board. Some groups, particularly younger, healthier men, could see big increases in premiums, while older, sicker consumers could see costs drop. That’s because the Affordable Care Act, or Obamacare, prohibits underwriting plans based on health status, and it limits the gap in premiums insurers are allowed to charge between the young and seniors. Rural areas might also see higher premiums than cities, due to less competition.

The state exchange is partly designed to coax the state’s uninsured into buying coverage. Nearly 25 percent of Nevadans are uninsured — one of the highest rates in the nation. People who make less than $45,960 as a single or $94,200 as a family of four get a federal premium tax credit if they buy through the marketplace.

The exchange won’t have enrollment numbers until consumers actually begin paying for coverage. Officials say they hope to sign up 118,000 Nevadans in the first year.

The exchanges opened in spite of a federal government shutdown that began at midnight. Hager said the closure won’t affect the state exchange as long as it’s short-term.

“Any kind of long-term shutdown — who knows how long — could affect the exchange, but at this point, we have the funds to continue to operate,” Hager said.

Contact reporter Jennifer Robison at jrobison@reviewjournal.com. Follow @J_Robison1 on Twitter.