Heather Korbulic is the new head of Nevada’s federally supported state health care exchange and marketplace. The seven voting-member board of the Silver State Health Insurance Exchange appointed her to the position of executive director on Sept. 20, replacing Bruce Gilbert, who stepped down earlier this year after two years in the post.
Korbulic served for eight years in Nevada’s Aging and Disability Services Division as the state’s Long Term Care Ombudsman before joining the exchange as chief operations officer in 2015. She is a graduate of the University of Oregon with a Bachelor of Science and is a Certified Public Manager.
Q: How has your past experience in health care administration prepared you for the challenge of this executive directorship?
A: My professional experience has always involved health policy, specifically as it applies to consumers and how to offer a great level of service. Working within policy and also on policy. In my role as chief operations officer I was able to learn a lot about the dynamics of the very interesting, always changing Affordable Care Act. I was intimately involved with all of the operational aspects of the exchange, from relationships with stakeholders, to our projects, grants, our relationships with the federal government and sister agencies. So I feel uniquely suited for this position.
Q: How do you assess the progress of the exchange since the problems it encountered during the first years? (the organization severed ties with contractor Xerox in 2014 following more than a year of significant software troubles)
A: The exchange has been incredibly successful the last few years. Last year we increased our enrollment more than 20 percent. We had an opportunity this past year — during the off cycle — to utilize grant funds for a successful off-season outreach campaign with the theme: Get to Know the Benefits of Health Insurance. That has really offered us an insight into our consumers — their questions, their interests. And it has been meaningful to us in terms of outreach and we are hoping to build on that success with our new campaign that will come out for open enrollment with the theme: Get Connected. We are excited about this open enrollment and hope it will be our biggest success yet.
Q: Is the move to the healthcare.gov enrollment platform (in 2014) expected to be permanent?
A: Right now we are in the process of determining that. We are negotiating long-term rates with the federal government and it has to be determined if they can meet our price point to remain on healthcare.gov. It is still in the works, but we will be on healthcare.gov in 2017 and most likely 2018, at this point.
Q: You have linked vendor participation in Medicaid managed care with participation in the exchange also. Has this proven a successful strategy for keeping vendors involved in the exchange?
A: It is currently in the contract that insurance carriers who operate Medicaid managed care are required to sell on the exchange. Sometimes our clientele comes from the exchange onto Medicaid and then from Medicaid onto the exchange. So this is really helpful in terms of churning through the two systems and it limits the disruption for the consumer.
Q: The Affordable Care Act has been a political lightning rod since well before it was enacted in 2010 and remains under threat, with public opinion deeply divided. Your thoughts?
A: In terms of politics, people don’t like the way the bill was passed, for sure. It is a new and vast policy that covers a lot of components and areas and is not a perfect policy in any way, shape or form. But ultimately, there are components that are popular.
For the most part, I think people appreciate that they can have their child remain on their plan until they are 26-years-old. They appreciate and support that people with pre-existing conditions can now access health insurance. For the most part, people appreciate that more people have access to qualified health plans. And ultimately that has reduced the billions of dollars that has been spent, historically, as a result of people who did not have health insurance.
Q: What has been the program’s impact to date on the state of Nevada’s health care?
A: What it has done for Nevada — since the Affordable Care Act was rolled out — over 300,000 people obtained coverage between Medicaid expansion and the plans sold on the exchange. We have been able to drastically reduce the number of uninsured children in Nevada, and specifically the number of Hispanic and Latino children.
Q: Yet the state’s number of uninsured children, per capita, remains in the highest quadrant nationally (specific state rankings vary, depending on included data and other variables). What needs to be done to see continued reduction in that number?
A: Our role is to make sure that education and outreach are offered to every population, specifically to some of those under-insured populations. To either direct them to appropriate benefits through a health plan on the exchange or to Medicaid services that might be available to them.
Q: What are your thoughts on the gap that exists between people eligible for the exchange and the people eligible for Medicaid or Medicare (between 100,000 to 150,000 people who are not eligible for any of these three, according to statistics from the Kaiser Family Foundation)?
A: That is certainly something we address. We work collaboratively with the division of welfare and supportive services who determine eligibility for Medicaid services. We are talking to them constantly, asking for re-assessments about consumers who come to our attention that could potentially be in this gap.
And we work closely with our partners at healthcare.gov and Centers for Medicare and Medicaid, to not only find services for those individual consumers, but also to make sure the agencies understand there are still gaps in this policy that need to be addressed.
Q: Open enrollment returns Nov. 1. Do you have advice for people interested in seeking insurance?
A: We encourage all our consumers, those who are returning or will be enrolling for the first time this year, to really seek through our website – we have a tool – to get enrolled through a licensed enrollment professional or certified assistor. That helps people find plans that are specifically suited and tailored for their individual needs. No two people are the same and each plan offers something a little bit different.
Q: And you are hosting upcoming events intended to assist consumers in enrollment?
A: Our kickoff events are Nov. 1 at the Cashman Center and in Reno at The Peppermill. That is an opportunity to have an enrollment assistor professional help our consumers enroll. Returning consumers can auto re-enroll, but we think it is a really good idea to shop the market, because it changes every year and consumers’ needs change every year so we think it’s always a good idea to look at what is available.