Rep. Matt Dean and Department of Human Services Commissioner Lucinda Jesson agree about MNsure. Well, anyway, they feel the same about one recent bit of news. More specifically, they agree on the term that should not be used to describe that development. Beyond that, their accounts share little in common.
Dean, the Dellwood Republican who chairs the House Health and Human Services Finance Committee, and Rep. Greg Davids, R-Preston, held a Monday morning press conference to keep the heat turned up on the insurance exchange. In light of revelations the previous week that some 180,000 Minnesotans insured through public programs were caught in a re-enrollment backlog, the Republicans renewed their call for the state to begin phasing out its involvement with MNsure, and transitioning to the federal healthcare.gov system.
The backlog is not the result of a “glitch,” Dean said, but is reflective of “systemic” and “cultural” problems with MNsure, which has suffered under flawed technological operations since its inception.
Dean and other legislators learned of the re-enrollment problem in a letter from Jesson. Interviewed after the press conference, Jesson agreed that the backlog is more than a “glitch,” but said Dean’s view leaves out a development that is equally important, if not more so: The planned auto-enrollment feature is now operational, meaning the re-enrollment backlog would not be a problem in future years.
“While we need to, and have already started tackling the backlog,” Jesson said, “I don’t want to let that get in the way of also celebrating the fact that we do have our auto-enrollment feature in place going forward.”
The net impact of the enrollment snags remains to be seen, as some 60,000 people affected have not responded to DHS inquiries about their status. Jesson said letters informing those people, who are evenly split between MinnesotaCare and Medical Assistance, the state’s Medicaid program, were to have gone out late last week or early this week.
Upon issuance of the letters, the unresponsive enrollees would have a 30-day window to reply, plus a 10-day closing notice, meaning their statuses should be resolved by the end of August, Jesson said.
But the re-enrollment problem was just the latest paperwork or technological error highlighted by Dean and Davids, who also passed out a list of links to news stories detailing the past year of delays and false starts. Davids, chair of the House Taxes Committee, said he had been trying to warn of imminent risks before MNsure’s launch, in 2013, and was then called a “fearmonger,” but said the continued existence of technological gaps had proven him right.
“Sometimes in life, you have to admit you failed,” said Davids, who also serves as co-chair of the MNsure Legislative Oversight Committee. He added: “We’ve spent $200 million, most of it on [information technology], and we’re still sending applications to [insurance] carriers on Excel spreadsheets.”
Davids said he was calling on Sen. Tony Lourey, DFL-Kerrick, his Senate counterpart on the oversight panel, to convene a hearing as soon as possible, and he followed up with a letter to that effect on Tuesday.
Lourey, interviewed later that day, said he had not been avoiding such a hearing but was hampered by the difficulty of scheduling a date that would work for the variety of authorities involved, including MNsure staff and board members and officials from DHS, Mn.IT and the Department of Commerce, not to mention the committee’s 10 legislators.
Dean and Davids said the oversight committee should begin discussing how MNsure could eliminate some of its operations and start the process of being absorbed by the federal insurance system, as both Oregon and Hawaii have done.
During the legislative session, Democrats and administration officials had argued that Minnesota could not risk transfer to federal control prior to the U.S. Supreme Court decision on federal subsidies for the three dozen states that do not run their own exchanges. The court ruled in June to preserve that aid money, which Dean said removes the key barrier to eliminating MNsure.
“The real question for MNsure,” Dean said, “is, ‘Why are you here, if what you are doing is only causing more problems for Minnesotans?’”
Lourey and Jesson said major changes for MNsure should, and would, be on the table, but both felt the appropriate venue for that conversation was the advisory task force created as part of this year’s health and human services budget bill, and not the legislative panel.
“That’s a bit much for the [legislative] oversight committee,” Lourey said. “That’s not really their role. They can certainly ask questions, and get a good sense of what’s going on with the task force … which is going to have many more stakeholders at the table.”
To this point, not much is going on with the task force: The Senate majority has named its members — Lourey will be joined by DFL Sens. Kathy Sheran (Mankato), Jeff Hayden (Minneapolis) and John Marty (Roseville) — and is awaiting the members provided from the other three caucuses. Lourey said he hoped the task force could begin meeting by the end of August at the latest, given the group’s outsized responsibilities.
On Monday, the Republicans had not been prescriptive in how the state could eventually eliminate unnecessary or duplicative functions of MNsure if it switched to the federal process. Dean suggested DHS could be able to “salvage” some working and essential pieces while canceling any duties that would be better handled through healthcare.gov.
Jesson, meanwhile, observed that moving to the federal program would almost exclusively have an effect on Minnesotans who are using the exchange to access the commercial market. If the federal website determines that an enrollee might be eligible for Medicaid coverage, it would simply refer them to the state DHS to handle enrollment in Medical Assistance coverage.
In that event, Jesson said, the person would still be relying upon state and county infrastructure that has been upgraded as part of MNsure.
“We were dealing with an antiquated, decades-old [IT] system that has to be replaced, and going to the federal exchange doesn’t solve that problem,” Jesson said.