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Nevada's health insurance exchange debuts Tuesday

Sandra Chereb, Associated Press

CARSON CITY, Nev. (AP) -- Early Tuesday, just after the stroke of midnight, officials in charge of Nevada's health insurance exchange will be glued to computer screens watching for glitches as the state's online insurance marketplace goes live.

Workers at call centers will be ready to assist consumers should they feel the urge to purchase health insurance before dawn.

But consumers may be wise to wait until the kinks are worked out and all the functions of the state's website, http://www.nevadahealthlink.com , are running smoothly.

"There are bugs. There are things we're finding. There are glitches," said Shawna DeRousse, chief operations officer for Silver State Health Insurance Exchange, a state agency created to oversee Nevada's online insurance marketplace.

There is no rush to buy. Insurance can be purchased before Dec. 15 for coverage to take effect Jan. 1. Enrollment will remain open through the end of March.

A lot of critical information consumers will need to make an informed choice that won't be released until Tuesday — the same day the exchange debuts. That's when details of which doctors, hospitals and other health care providers are participating in individual insurance networks will be released.

That's also when consumers will be able to research policies to see whether specific medications are covered — and at what out-of-pocket costs.

Health exchanges are part of President Barack Obama's sweeping health care reform law that requires everyone to have medical insurance by 2014 or pay a fine. Nevada was one of the first states in the nation to take steps implementing a statewide exchange.

About 22 percent of Nevadans — roughly 617,000 — lack health insurance.

Under the law, people making up to four times the federal poverty level are eligible for federal subsidies to reduce the amount of their monthly premium. That threshold is $45,960 for a single person and $94,200 for a family of four.

Republican Gov. Brian Sandoval agreed to expand Medicaid coverage in Nevada, as called for under the law, meaning thousands of people previously ineligible for benefits — mainly single adults without children — will now qualify if they make less than $15,415 a year.

Four insurance carriers are offering policies through Nevada's Silver State Health Insurance Exchange, but only two, Nevada Health Co-op and Anthem, offer plans statewide. The other carriers are Saint Mary's and Heath Plan of Nevada, which exclude coverage in 10 rural counties. Rates for residents vary depending on where they live, how old they are and their annual income.

The website is supposed to be a one-stop shopping portal, where people can compare insurance plans and costs, be referred to Medicaid or other services for the poor if they qualify, and have federal subsidies calculated if thresholds are met.

But some functions won't be ready on the rollout date. A Spanish-language portal is being pushed back until mid-November. A filtering system to sort plans by cost, prescriptions or providers is also delayed, so consumers will have to search each individual plan and take notes to make comparisons.

Exchange officials also postponed until November an aggressive television ad campaign urging people to sign up.

Instead, they're hoping for a "soft" launch of the exchange so they have time to identify and fix any lingering problems before the sign-up deadline nears and more web traffic is expected.