More than three years after passage of the federal Patient Protection and Affordable Care Act, Minnesota’s health insurance exchange opened for business on Tuesday. The MNsure website had more than 100,000 visitors on opening day, and more than 500 people created accounts in just the first hour of operation.
“We are very happy and pleased to be open this afternoon,” said April Todd-Malmlov, MNsure’s executive director. “We have had great interest today.”
But the rollout of the health insurance marketplace, where 1.3 million individuals are eventually expected to obtain coverage, left largely unanswered many questions about how well the system will function. That’s in part because the website where people can shop for coverage didn’t go live until after 3 p.m. on Tuesday.
As anticipated, there were some glitches on startup. At least one key feature of the site – the ability to look up whether a specific medical provider is p
art of the network for an insurance plan – was not working. In addition, the site initially will not be available from 10 p.m. to 6 a.m. each day in order to allow for ongoing maintenance. There were also problems with account creation owing to server problems.
In addition, Native Americans were advised to wait a week before seeking coverage through the state-run exchange, because the computer system was having problems calculating the correct subsidies available for those individuals. MNsure officials indicated that they’ve identified the problems and expect to have them fixed within a week.
Further complicating the rollout, MNsure officials said they would not begin certifying roughly 5,000 individuals – insurance brokers, nonprofit employees, government workers – who will help people obtain coverage until Wednesday.
“We know there’s been a few bumps in the road both for us and for the federal government as well, but we are tracking those, addressing them and fixing them as they come up,” said Todd-Malmlov.
Despite the first day turbulence, proponents of the health insurance exchange expressed satisfaction with MNsure’s much-anticipated debut. In particular, they stressed that Minnesota’s exchange will offer the lowest rates in the country for many groups of individuals.
“So far, so good,” said Rep. Joe Atkins, DFL-Inver Grove Heights, the lead author of exchange legislation in the House. “I’m cautious by nature, but optimistic that it’s going to turn out fine. Obviously it’s a long day and a long week and we’ll see how it all shakes out.”
Sen. Tony Lourey, DFL-Kerrick, the lead author of exchange legislation in the Senate, pointed out that plans purchased through MNsure won’t become active until January 1, so there’s plenty of time to work out any kinks. “I don’t think there’s going to be a lot of people closing the deal in these first few days,” Lourey said. “It’s more kicking the tires.”
But skeptics of the viability of a state-run marketplace expressed concern that it was rolled out prematurely in order to meet an arbitrary deadline set by the federal government. Specifically, they stressed concerns about data security given an earlier breach in which personal information concerning more than 1,500 insurance brokers was inadvertently released.
“I think they were under tremendous pressure to comply with the law instead of doing good project management,” said Sen. Michelle Benson, R-Ham Lake, the ranking minority member of the Health, Human Services and Housing Committee. “We’re going to keep finding stumbles and missteps. I don’t think they did good testing on this.”
No rush to acquire coverage
The Anoka County Human Services Center, in Blaine, has set up a room on the fourth floor where individuals seeking coverage through MNsure can learn about their options in the fledgling marketplace. The county is sharing the space with the Anoka County Community Action Program (ACCAP). County workers will enroll individuals who qualify for public plans (i.e. Medicaid and MinnesotaCare), while those who need to purchase private coverage will be assisted by ACCAP employees.
According to Jerry Vitzthum, Anoka County’s director of economic assistance, they’ve added 17 workers to handle the expected influx of people seeking coverage. But at 1p.m. on opening day, with the enrollment system not yet functional, no one was seeking insurance.
“If the thing works as it’s eventually supposed to, it could make our lives a lot easier,” Vitzthum said. “If it doesn’t work that way, then it could make more work for us. That’s the only concern we have.”
At Portico Healthnet, a nonprofit group in St. Paul that helps people acquire health insurance, the first day was similarly quiet. The group expects to eventually have 15 workers certified to sign people up for coverage through MNsure, but that process won’t begin until Wednesday.
“We’re finished with training,” said Rebecca Lozano, Portico’s outreach manager. “We are ready to hit the ground running as soon as we get the go ahead from MNsure.”
Portico has hired four additional health outreach workers and is partnering with 10 other social service organizations to spread the word about the availability of coverage. “The four community health workers that were hired specifically to do this work will be constantly rotating through these organizations,” Lozano said. “It’s really serving the client to the best of our ability in partnership with these other organizations.”
Debra Holmgren, Portico’s president, said that the hiccups in the MNsure rollout haven’t caused significant anxiety about how the system will ultimately function. “Historically when something new opens up like this, it’s a lot slower start,” Holmgren said. “I think we’re just ready to get started.”