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Delaying transition for public-coverage holders could smooth process

ST. PAUL — Minnesota officials have slowed a massive transition of public insurance beneficiaries to the new MNsure system, but say the health insurance exchange still will meet projections for 1.3 million enrollees by 2016.

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As of May, the exchange had enrolled more than 200,000 in public and private health insurance — less than one-fifth of the long-term projection for coverage through MNsure.

One key to bridging the gap is helping about 800,000 people renew their current public health insurance coverage through MNsure, said Lucinda Jesson, a MNsure board member who also is the state’s human services commissioner.

The process was supposed to start in April but has been delayed until August and will move at a slower pace than originally planned. The new plan allows for improvements to the troubled MNsure information technology system, plus measures to prevent people from inadvertently losing coverage.

“We wanted to make sure that the system functionality could handle this number of people coming through,” Jesson said. Of the 2016 enrollment projection, she said: “I feel like we are very much on track.”

Minnesota launched the MNsure health insurance exchange to implement the federal Affordable Care Act, which requires almost all Americans to have coverage or pay a tax penalty.

The majority of Minnesotans get health insurance from their employer or the federal Medicare program. Those who don’t can use MNsure to buy private coverage or enroll in the Medical Assistance and MinnesotaCare public health insurance programs.

The projections for 2016 enrollment come from a consultant’s report, which forecast the majority of MNsure’s business would come from people obtaining public insurance coverage.

Since October, people who are newly eligible for the state programs have been enrolling through MNsure. Another 800,000 people previously covered through Medical Assistance and MinnesotaCare soon will be asked to start renewing their existing coverage through MNsure.

This “conversion” process has worried county officials who have struggled for months trying to use the MNsure system to help just the smaller group of people newly eligible for public insurance.

“The thought of transitioning all of the current Medical Assistance recipients … into a system that is functioning the way that it is now is untenable,” said Deborah Huskins, a Hennepin County official, during a MNsure board meeting in April. “If that were to be the route taken … we would lose some people — they would lose the health care coverage that they need.”

State officials want to prevent disruptions, so they delayed the start of the conversion from April to August, Jesson said. Whereas the state originally planned on about 70,000 people converting their coverage each month, the current plan asks 14,000 people to do so in August and another 14,000 in September.

Letters explaining the conversion will start going out to beneficiaries this month, Jesson said. The letters will include user names and temporary passwords so people can access their MNsure accounts.

There also will be instructions about where people can get help, Jesson said. Beneficiaries also have the option of using paper applications.

“We are really proceeding with care here, because these are things where we can alter our approach if it’s not working,” Jesson said.

If things go well this summer, another 100,000 people will make the transition this fall, Jesson said, followed by another 700,000 beneficiaries in 2015.

“We are taking this in a slower, more careful, pilot-oriented fashion,” Jesson said. But when it’s done, she said, the exchange will have taken a large step toward hitting the projected number of enrollees.

When the state Legislature created MNsure in 2013, supporters repeatedly cited projections that 1.3 million people would be enrolled by 2016, including about 300,000 who previously lacked coverage.

This week, University of Minnesota researchers released a report suggesting the state is more than halfway to hitting the 2016 forecast for reducing the number of uninsured residents. The report included figures for MNsure enrollment as of May 1.

The long-term projection anticipated about 452,000 people would obtain commercial coverage through MNsure by 2016. As of May 1, about 43,000 used the exchange to obtain commercial insurance, but the number has since ticked up to about 50,000, said Scott Leitz, the MNsure chief executive.

Currently, MNsure’s budget expects another 50,000 to enroll in commercial coverage for 2015 and another 50,000 to enroll in coverage for 2016. MNsure isn’t backing away from the original projections for commercial enrollment, Leitz said, but the numbers don’t constitute current goals for the exchange, he said.

“We’re doing everything we can to get as many people into coverage as we can through MNsure, and that’s really our goal,” Leitz said.