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Published January 19, 2014, 04:35 AM

Biggest test of MNsure success still to come

It’s halftime for MNsure, and it’s tough to tell what the score is.

By: Christopher Snowbeck, St. Paul Pioneer Press, INFORUM

It’s halftime for MNsure, and it’s tough to tell what the score is.

On Wednesday, the state’s health insurance exchange passed the second of four enrollment deadlines for people seeking 2014 coverage through the new government-run marketplace. The next comes in mid-February, followed by an expected flurry of activity before the current open-enrollment period ends March 31.

Between Oct. 1 and Jan. 4, nearly 71,000 people moved into the final stage of enrolling in government or commercial health insurance programs through MNsure. Whether the tally is a lot or a little depends on the yardstick.

Legislators sounded alarms this month over a possible budget deficit in MNsure’s future due to both low commercial enrollment trends and low premiums. But one health policy group’s analysis provides a somewhat favorable impression of enrollment trends in Minnesota compared with the nation.

Insurers point out that success depends on more than numbers, since the exchange must attract enough young and healthy consumers this year to prevent premiums from spiking next year. That’s why it’s critical, they say, that MNsure solve lingering problems with its website and call center before March rolls around.

“My expectation would be: As many people are going to enroll in the last 10 days in March as are going to enroll between now and the middle of March,” Scott Keefer, vice president of policy and legislative affairs at Blue Cross and Blue Shield of Minnesota, said during a Tuesday interview. “I think it’s so important to be prepared for that surge of people, so you’re not experiencing long wait times and delays – and people can largely get into the system.”

Minnesota launched the MNsure online marketplace last year to implement the federal Affordable Care Act, which requires almost all Americans to have health insurance or pay a tax penalty. When evaluating MNsure’s performance thus far, some factors are tough to gauge.

For individual consumers, the process of trying to obtain MNsure coverage has varied dramatically. Some have gotten insurance after spending just an hour or two on the computer. Others have experienced weeks of agony, including website glitches and hours of waiting for help from MNsure’s overwhelmed call center.

Looking at numbers

Enrollment numbers released thus far point in different directions.

As of Jan. 4, about 26,000 people were in the final stage of enrolling in a commercial health insurance plan through MNsure. At that pace, commercial enrollment is falling short of even the low end of MNsure’s projections, state officials said this month.

Consumers use the health exchange to find out whether they qualify for the MinnesotaCare or Medicaid public health insurance programs, and the state has had more success getting people into Medicaid. The state already has exceeded enrollment projections for Medicaid but isn’t yet halfway to its goal for MinnesotaCare enrollees by March.

In Minnesota, there are relatively few exchange customers because the state has a low rate of people who previously lacked health insurance and a high rate of employers who provide coverage, said Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation.

The California-based health policy group took these factors into account last year when developing state-by-state estimates for the total number of people who would be eligible to shop each state’s health exchange. A new foundation analysis based on exchange enrollment numbers released Monday suggests that Minnesota is doing relatively well, with 8.7 percent of the potential market having selected a commercial health plan, Tolbert said.

Across the country, 7.8 percent of the potential market had selected an exchange plan, according to the foundation’s analysis.

Consumer experience

Scott Leitz, interim chief executive of MNsure, said cross-state comparisons are difficult because performance doesn’t involve just enrollment statistics. Consumer experiences also are key, and MNsure must improve its website and call center, Leitz said.

Wednesday’s enrollment deadline at MNsure wasn’t nearly as busy as a previous deadline Dec. 31, yet it still resulted in call center wait times that exceeded one hour on average. On Thursday, MNsure officials said they are considering whether to use in the future an external call center that would handle a portion of all calls.

“We’re going to add resources to the call center – and they’re going to be substantial resources,” Leitz said.

The report also showed Minnesotans were much more likely than people elsewhere in the country to sign up for “platinum” policies that have the richest benefits.

The Pioneer Press is a media partner with Forum News Service.