“The Silver State Health Insurance Exchange board voted unanimously Tuesday to end its relationship with Xerox, the vendor contracted in 2012 to build the exchange’s Nevada Health Link website.

In place of Xerox, the exchange will adopt the federal Healthcare.gov exchange’s eligibility and enrollment functions for the sign-up period that begins Nov. 15, though it will keep its status and funding as a state-controlled system. The exchange will also issue a request for proposals to evaluate replacement systems in coming years. A new platform could come from a state with a functional marketplace, or from a vendor with a similar, proven program.”

“Healthcare reform has largely ignored the poor. The healthcare safety net has far too many holes, and the Affordable Care Act builds on a flawed system of health insurance. Lower income families, especially those enrolled in Medicaid, have a difficult time finding doctors who will accept their coverage. Insurance is of little value if doctors will not work with your insurer.”

“A large number of people who’ve signed up for private health insurers through the Cover Oregon health insurance exchange have not paid their first month’s premiums, meaning they are at risk of going without coverage through November.”

“State officials disclosed a $300 million shortfall in state revenue collections Monday, putting the state’s stellar bond rating in jeopardy — and placing new pressure on lawmakers and Gov. Terry McAuliffe to break their budget deadlock.”

“Indiana Gov. Mike Pence said Monday President Barack Obama’s health care law must be repealed but urged his fellow conservatives to offer alternatives to the president’s policies. The Republican governor introduced his state proposal that he says would act as an alternative to Medicaid. In a speech to the American Enterprise Institute, Pence said his plan would help expand health coverage for low-income residents but provide more flexibility to allow people to manage their own health care needs.”

“I have been a huge fan of the popular Healthy Indiana Plan since it was conceived by former Gov. Mitch Daniels in 2008 as a way to expand sensible health coverage to uninsured Hoosiers.

Daniels’ successor, Gov. Mike Pence, is unveiling his own 2.0 version of the Healthy Indiana Plan (HIP) during a talk at the American Enterprise Institute today, but the plan already is getting a great deal of pushback from conservatives. The original HIP program relies largely on state funding, but the new version will draw primarily on federal funding by expanding Medicaid, an option granted to the states under the Supreme Court’s rewriting of the ACA.”

“From the beginning of my tenure as governor in 2013, we have been saying no to ObamaCare in Indiana. We refused to set up a state-based exchange, and we have said we will not expand traditional Medicaid. We have a better alternative in a program that offers Indiana’s working poor the chance to get insurance and control their own health care.”

“A top insurer in the North Carolina Obamacare exchange reported that its customers are both older and less healthy than it expected and warned that premiums are likely to rise next year.

“Not as many of the state’s young and healthy enrolled as expected,” Blue Cross Blue Shield of North Carolina announced in a press release. The company expected 50 percent of its Obamacare exchange customers to be younger than 35, but just 32 percent of customers are below age 35 and just 25 percent are between the ages of 18 and 34.”

“Indiana Gov. Mike Pence on Thursday said he wants to use Medicaid funding under the federal health-care law to expand coverage in his state, but that any expansion of it would have to come on his own terms.

The proposal is the latest from a small group of mostly Republican governors pursuing alternative ways to tap billions of dollars in federal Medicaid money available under the Affordable Care Act. Most GOP governors are refusing the additional federal money outright, while those who have wanted to expand Medicaid faced objections from GOP-led legislatures.”

“States that experienced severe technical problems in running their ObamaCare exchanges would have to reimburse the federal government for the cost under a Republican bill introduced Wednesday.”