They’re working on it.
That was the word Friday from officials with the Silver State Health Insurance Exchange, who reported their most recent sign-up numbers earlier this week even as they continued to wrestle with technical difficulties and high call volumes.
The exchange nearly tripled in a single week the number of people who selected plans through its Nevada Health Link marketplace, though enrollments remain well below early forecasts of how many people would sign up. But Barbara Smith Campbell, chairwoman of the exchange’s board of directors, said the system’s managers are trying to improve things every day.
“This is a monumental, new technology and implementation that has so many complex moving parts,” Campbell said. “For those of us who have been involved from the onset, we knew it was going to be difficult, and we knew there would be many challenges once the system was coming online. I’m proud of the tremendous amount of work we’ve done to date, but I’m far from being satisfied that we’ve reached our goal of having a consumer-friendly, functional product.”
That may show in the newest sign-up figures.
The exchange’s website at www.nevadahealthlink.com has had 5.4 million site visits, including 940,000 visits the week of Dec. 2 alone, representatives said in their weekly update Tuesday.
Relatively few of those visitors have gone ahead with coverage: As of Sunday, 6,629 Nevadans — including 1,800 during the week of Dec. 2 — had selected qualified health plans. But choosing a plan isn’t the same as paying for it, and a consumer isn’t considered enrolled in coverage until she writes a check for that first monthly premium.
Exchange spokesman CJ Bawden said 1,537 people had actually paid for coverage by Sunday, double the number of payments from a week earlier. The pace has picked up as the Dec. 23 deadline looms to sign up for a plan that takes effect Jan. 1.
Bawden said many of the remaining people who have chosen plans will convert to paid enrollments, because most of them have scheduled payments. The exchange doesn’t include scheduled payments in its enrollment stats.
Even if all 6,629 people who’ve selected plans enroll, the exchange has a way to go before it reaches its March goal of 118,000 sign-ups.
Exchange officials made that forecast based on how many Nevadans lack health coverage, Campbell said. About 600,000 residents in the Silver State are uninsured, a rate that routinely ranks in the top five nationally.
“When we get to March, we’ll see how close we are to that number (118,000),” she said. “I’m not good with the crystal ball, but I hope we get very close to those numbers.”
Added Bawden: “That number was always an estimate. We’ll see exactly where we are when things shake out March 31. Right now, we’re on trend, with enrollment doubling weekly.”
The newest plan-selection number equals just 1.1 percent of the state’s uninsured, though Medicaid’s expansion to include some childless, single adults is supposed to pick up more than 100,000 of those without coverage.
Representatives of the state Department of Health and Human Services didn’t respond to an e-mail asking for an update on Medicaid applications.
Nevada’s sign-up numbers are also less than the 25,000 residents who lost coverage this fall as insurers canceled plans that didn’t comply with Obamacare’s benefit mandates.
Compared with other states, Nevada’s exchange experiences fall toward the middle of the spectrum. Large states such as California are posting tens of thousands of plan selections. Other markets have fared far worse than Nevada. Take Oregon, which has nearly twice Nevada’s population. Fewer than 50 Oregonians had signed up for coverage by Nov. 30, according to the U.S. Department of Health and Human Services. In Kansas, which at 2.8 million people has roughly the same population as Nevada, 1,855 residents had chosen an exchange plan.
Just as important as enrollment is the demographic breakdown of who’s signing up. The exchange needs strong participation among younger, healthier Nevadans to help keep premiums down. Bawden said exchange officials will release their first demographic profiles after Jan. 1.
The exchange’s fortunes are tied in big part to how well its website and call center function — a problem given the exchange’s ongoing technical difficulties. Recent posts on its Twitter feed and Facebook page said “extremely high call volume” meant busy signals for consumers who tried to call Tuesday. The exchange said it was “working to increase call center capacity” and recommended that people try after 6 p.m.
Another Tuesday post said some people were getting a “white screen error” during eligibility determination.
Some consumers responding to the posts said they’d been trying unsuccessfully to log into their account for two months. Others said they were able to make it through the exchange’s online application process afterhours.
Bawden said the exchange has “planned fixes on a weekly basis” to repair the eligibility function.
Plus, the call center is set to expand from 60 workers to 90 in the next week or so, Campbell said. Its hours may increase, too. Right now, the call center runs from 8 a.m. to 8 p.m. Monday through Friday, and from 9 a.m. to 3 p.m. on Saturday and Sunday.
Contact reporter Jennifer Robison at firstname.lastname@example.org. Follow @J_Robison1 on Twitter.