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First enrollee lawsuit filed against MNsure

MNsure CEO Scott Leitz, pictured above, is named in James Taylor’s suit against MNsure, along with Human Services Commissioner Lucinda Jesson. MNsure and DHS both declined to comment on the pending litigation. (File photo)

MNsure CEO Scott Leitz, pictured above, is named in James Taylor’s suit against MNsure, along with Human Services Commissioner Lucinda Jesson. MNsure and DHS both declined to comment on the pending litigation. (File photo)

James Taylor will be voting for Gov. Mark Dayton in the fall, but the Cottage Grove man doesn’t have much patience left for MNsure.

In late May, Taylor, 61, filed what is believed to be the first lawsuit against the exchange. According to court documents, Taylor struggled through repeated attempts to enroll in insurance coverage and eventually appealed the exchange’s rejection of his eligibility for MinnesotaCare.

After that appeal got thrown out on May 20, Taylor (who declined to be photographed for this story) filed a lawsuit in Washington County. His case is emblematic of the technical issues that have plagued the marketplace since its launch last October.

Despite the problems that have followed his journey toward health coverage — Taylor was ultimately determined eligible for MinnesotaCare and now is covered under that public program typically aimed at the working poor — he’s an affable man who doesn’t come across as bitter. A supporter of the federal health care overhaul, Taylor said in an interview Tuesday at his home that he’s not sure why he’s had so many problems getting coverage.

“I think Barack Obama is one of the greatest presidents in history for coming up with this idea, but the implementation of it here — and Gov. Dayton [is] great for supporting this idea — but somewhere in that hierarchy things fall apart, and it’s been widely publicized that that’s the case,” Taylor said.

The former 3M employee is representing himself in the suit. He’s seeking $2,127 for medical expenses he incurred between January and March when he says the state incorrectly denied him access to public programs or tax credits to help him pay his premiums.

In its rejection of Taylor’s appeal, the state said he didn’t qualify for public programs or tax credits because he still had an employer-sponsored health plan during that time.

A quiet retiree who bikes frequently, Taylor was reluctant to explain some of the other details of his case, but his knowledge of the exchange was clear. There isn’t a hearing scheduled yet as part of the lawsuit, which Taylor filed on May 29.

The Department of Human Services (DHS) ultimately determined him eligible for MinnesotaCare beginning in March, and now Taylor pays a $50 premium each month. That’s down from $714 a month for his employer-based coverage, according to a state appeals document.

Similar to his support for the Affordable Care Act, Taylor is quite happy with the coverage he has now. He’s just frustrated with the path it took him to get here.

Taylor said he had four different health plans at various points in the period he’s suing over. Just getting logged into the website took almost six weeks, he said, and ultimately technical glitches — he couldn’t access the correct application at home or at the local library — forced him to use a paper application.

Though he began attempting to purchase coverage on Oct. 1, technical issues delayed his application until mid-December. “This was a process that was supposed to take 20 minutes,” Taylor said. “That’s what it said right on the website when I first sat down and looked at it.

“I am saving a lot of money, I will say that, but it’s taken me a long time to get there.”

DHS: no comment

MNsure CEO Scott Leitz and Department of Human Services Commissioner Lucinda Jesson were named in the suit. Representatives of DHS and MNsure said their organizations don’t comment on pending litigation.

“This is the first lawsuit against MNsure, but MNsure can’t comment further on this case due to pending litigation and privacy laws,” exchange spokeswoman Jenni Bowring-McDonough said in a written statement. “However, in general, administrative and judicial review of eligibility determinations is not unexpected, and is, in fact required to be made available to individuals under state and federal law. MNsure is committed to the principles of due process, including individual access to independent and objective reviews of an eligibility determination.”

The exchange has received slightly more than 1,200 appeals, Bowring McDonough said. According to MNsure documents, 81 percent of appeals are ultimately withdrawn by the consumer. The state’s decision is reversed in just 2 percent of appeals cases.

Consumers contesting MNsure’s decision have 90 days to protest an eligibility determination, or 30 days if they’re attempting to access a public program. A state appeals examiner then conducts a hearing and eventually offers a written decision.

Taylor acknowledged that it could appear outlandish for a consumer to go into a lawsuit lacking professional legal representation. And to him, it isn’t as much about the money as the principle of the situation. He firmly believes MNsure is wrong.

“I try to explain my situation to friends or family and I know they’re thinking, ‘What are you doing? Why are you spending all this time on this? You don’t have a chance,’” he said, adding: “I wouldn’t do something like this if I didn’t know what I was talking about, and I’ve put in a lot of research on this.”

Taylor said he also wants to feel like he’s being heard, which hasn’t happened yet.

About James Nord

2 comments

  1. I am having a total nightmare as well. Unbelievable. I am considering filing a suit. And I don’t sue people. I have been blocked out of mnsure for weeks, apparently because I was not “discharged” in 2012……..yep 2012. The fact that I have Minnesota care before for some reason, blocks your ability to buy insurance on the marketplace. I would LOVE to hear exactly why that is???? I needed up buying a policy at ehealthinsurance.com for more than I wanted to, and Im not even sure that you can buy insurance other than on the exchange. This have been unbelievable. Here I am, money in hand, plan in hand, and no one, and I mean no one, has been able to take my money and get me set up with a plan. I went and met with a navigator who told me that I was “all set” and was covered under minnesota care. Come to find out, that was not true at all. Luckily, I knew better and double checked. This has been the worst experience that I have ever had trying to buy something. Unbelievable.

  2. I would like to jump on board.
    I have been told by mnsure to reapply twice, yet the useless website does not allow or accommodate for it. Then they tell me to call and all I get is the runaround from an automated system that eventually ends up telling me there is a high volume of calls and to call back later. Well, unlike most of the welfare recipients who have all day to call, I have a job and cant waste my time every day hoping that I might get through. Now I have no insurance because the horrible but affordable major medical policy I carried before abomination care at $130/month is now $440/month in the so-called free market. So, I am subject to the obamacare fine which I WILL NEVER PAY, EVER, simply on the principle of the situation. We the people did not vote for this crap and the majority was against it. All we need to break the back of the health care industry fixed pricing is allow competition for health insurance nationwide, NOT by state!

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