- Associated Press - Thursday, March 13, 2014

CARSON CITY, Nev. (AP) - The board overseeing Nevada’s troubled health insurance exchange delayed action Thursday on whether to give people stuck in the system because of technical problems more time to complete enrollments.

Board members raised a number of questions on how the special enrollment period beyond the March 31 deadline would be implemented, and whether Nevada’s system operated by Xerox could handle the task.

Lynn Etkins, vice chairwoman of the Silver State Health Insurance Exchange board, noted that 345,000 people have started applications since Nevada Health Link went live Oct. 1. As of March 8, 30,000 people have selected plans through the website and only 21,000 have paid for premiums.

“Can the system handle this now?” Etkins asked. “I’m concerned about adding all of that volume.”

She said consumers already have endured months of frustration, and worried that adding a new category of special cases would further clog the system and add to the public’s anger.

“I don’t know how all of that would work,” Etkins said, calling the prospect “messy.”

To that, Chairwoman Barbara Smith Campbell replied, “What hasn’t been messy so far?”

“We have failed the Nevada citizens who have attempted to enroll through the health exchange,” she said. “I think it’s our responsibility to those people to give them every avenue … to finish the process that they started.”

One big issue is how to determine eligibility and from what point in the process eligibility would begin.

Would eligibility for an extension begin from when the application was started? When a plan was selected? When someone last tried to enroll?

Scott Kipper, Nevada’s insurance commissioner, cautioned that setting the starting point too far back, such as when a person first tried to apply, could be a nightmare for insurance providers.

Another concern is when policies issued under the extended deadline would take effect. Staff warned that making them retroactive could invite people who started an application early on with no intent of completing the process to try to jump back into the system after suffering a serious medical problem.

The board asked for recommendations from Kipper and more information from Xerox. It will consider the extension again when it meets March 20.