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June 22, 2024 8:11 am

Local News

Nevada Health Exchange closes year with surplus


Camalot Todd, Nevada Current
January 8, 2024

The Silver State Health Insurance Exchange, which oversees the virtual health care website, under the Affordable Health Care Act, closed the 2023 fiscal year with over $11.5 million in cash reserves for the fiscal year 2024, and projects an annual cost-saving of 20% in the fiscal year 2024, according to the biannual Fiscal and Operational report released on December 31. 

The state had to implement a special enrollment period for those who lost their Medicaid or Children’s Health Insurance Program (CHIP) coverage after the end of pandemic-era requirements extending care, operate the state’s fifth open enrollment period as a state-based exchange which has steadily grown due to federal expansions by the Biden Administration, and streamline requirements allowing for tribal members to be certified in enrolling their community in health care.

The $11.5 million in cash reserves for the fiscal year 2024 is an increase of $4.3 million from the project balance in the approved budget. 

The Exchange sets an annual fee for insurance carriers which allows the agency to operate and meet state and federal requirements without passing those costs onto Nevadans through increased premiums. The Exchange Board approved the fee rate of 3.05% of the pre-federally subsidized premiums in February 2023, which allowed the agency to collect nearly $15.3 million for the plans in 2023 and is projected to garner $14.9 million in 2024. 

The anticipated slight decrease in revenue is due to the “Exchange enrolling a high number of consumers” in current and previous years due to special enrollment periods like the Medicaid unwinding. But there is “no concern” that the fee will need to be adjusted, according to the exchange report.

As of December 1st, the Exchange had re-enrolled 2,099 individuals in health coverage following the termination of their Medicaid/CHIP benefits, according to the report. 

During the unwinding period in Nevada, several people who were disenrolled from Medicaid for procedural causes like missing or incomplete paperwork had their health care reinstated, with some of these people having applied for care through the Exchange, causing a duplication of health insurance coverage.  The Exchange is working with CMS and the Nevada Division of Welfare and Supportive Services to terminate duplicated coverage “as appropriate” according to the report.

Revenue for the Exchange has increased since fiscal year 2022 due to record-breaking enrollments. The American Rescue Plan Act helped extend eligibility for Exchange plans to people with incomes over 400% of the poverty level, which allowed more Nevadans to enroll for 2023 and 2024. 

The agency’s operating costs have not increased, said Silver State Health Insurance Exchange spokeswoman Katie Charleson via email.

“The Exchange requires a surplus to fund future legislative mandated projects and unforeseen costs related to the Exchange,” Charleson said.

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This article is republished from Nevada Current under a Creative Commons license. Read the original article.