Struggling health exchanges brace for Obamacare’s 2nd year

States that struggled to operate their health exchanges in Obamacare’s first round say they’re on sure footing with roughly five weeks to go before open enrollment starts again.

Some states have fired the contractors that developed their websites last time. Nevada scrapped its own website and instead will rely on the federal HealthCare.gov system for key functions in 2015.

Massachusetts’ exchange thinks it found a winning formula by replacing its main contractor and using “off-the-shelf” technology that worked in other states, while Oregon, which suffered a catastrophic digital rollout last time, says it’s done trying on its own, and will instead rely on the federal exchange.

The Obama administration says it is doing what it can to help each of the states flourish, although there is no one-size-fits-all solution.

“We are working on a state-by-state basis to provide the support, and the support is different in each of these states,” Health and Human Services Secretary Sylvia Mathews Burwell said last week.

The health exchanges allow uninsured Americans to shop for private health plans online, often with the help of income-based government subsidies. While many states allowed the federal government to run its exchange for them through HealthCare.gov, 14 states and the District of Columbia set up their own marketplaces.

Several had a woeful experience. Despite early enthusiasm in Oregon for the exchange, Cover Oregon was unable to sign people up online last time.

This year, plan and rate information from all 15 carriers on Cover Oregon has been loaded onto the federal HealthCare.gov, and the exchange will tell existing customers to re-enroll on the federal site, spokeswoman Amy Fauver said.

In Nevada, the exchange ran into so many hiccups during the open-enrollment season that officials gave consumers who were thwarted from signing up an extra two months to enroll. Officials announced in May the state would ditch its contractor and rely on the federal website for private-plan enrollment in 2015.

Customers will still begin the sign-up process on the state exchange website to see what they qualify for. From there, they will be directed to HealthCare.gov for qualified health plans or to the state’s Medicaid program.

“Major milestones are being hit and testing has begun,” Nevada exchange spokesman Tyler Klimas said Friday. “We will continue system testing throughout the month as we approach open enrollment.”

It sounds like Nevada may permanently go with the federal exchange. The Health Insurance Exchange Board voted last month to stop searching for a vendor to build a new state platform for the 2016 plan year.

“The focus remains on this upcoming open enrollment period and there has been no further board discussion on future platform changes,” Mr. Klimas said.

Other states salvaged their own operations instead of turning to the federal system.

Massachusetts’ exchange had a rocky first season, after the commonwealth failed to adequately revamp the state system that served as a model for President Obama’s exchange-based reforms.

Maydad Cohen, the second official tapped to lead the exchange’s turnaround after Sarah Iselin of Blue Cross Blue Shield started the process, said this week the exchange will work.

Exchange officials replaced their “underperforming vendor” with Optum, which had helped to fix HealthCare.gov, and they switched to technology that worked in Kentucky and Colorado, she said Thursday in prepared remarks to the exchange’s board of directors.

“I readily admit this hasn’t always been easy, and we made our fair share of mistakes. That sometimes happens when you take on a challenge this big,” she said. “We have learned from our mistakes, enlisted outside expertise, and made significant improvements both to this project and the state’s IT management generally.”