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Will MNsure cost taxpayers?

By Christopher Snowbeck, St. Paul Pioneer Press

ST. PAUL — MNsure is falling short of enrollment targets, and state legislators are questioning whether the health exchange might need more taxpayer support to fill budget gaps down the road.

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Scott Leitz, the interim chief executive at MNsure, said at a legislative oversight committee meeting Thursday at the Capitol that with current enrollment trends, MNsure isn’t even on track to hit the low end of its goals.

“We’re running right now at about 85 percent” of the lowest scenario, Leitz said.

MNsure officials hope the trend will improve as the health exchange tackles technology problems, ranging from website glitches to an overwhelmed call center. But lawmakers are concerned because the MNsure budget already faced a challenge since premiums for insurance policies in the state came in lower than expected.

Low premiums are good for consumers, but they hit MNsure’s operating revenue, which will come from withholding up to 3.5 percent of premiums, starting in 2015.

“It looks like MNsure loses money every year,” said Sen. Michelle Benson, R-Ham Lake, during the committee hearing.

Sen. Tony Lourey, DFL-Kerrick, followed up on Benson’s comment by asking whether MNsure expects to seek funds from the Legislature to cover operating costs.

In an interview after the meeting, Lourey noted the projected budget shortfall would hit in 2015 and 2016, but not this year.

“There is a little time to work on this,” he said, before adding: “They’re going to need to do some very serious work and internal reviews, and think very carefully about whether they come back to the Legislature for any solution to any potential budget shortfalls.”

Minnesota created the MNsure health insurance exchange to implement the federal Affordable Care Act, which calls on almost all Americans to have coverage starting this year. Operations currently are being funded with more than $150 million in grants from the federal government.

The health exchange rollout has been rocky, particularly during the last six weeks.

Beyond website glitches and call center wait times, MNsure has struggled to communicate information about enrollees to private health plans in a timely manner. Some people who enrolled in plans by Dec. 31 still don’t have health plan ID cards, although they should arrive soon.

This week, Legislative Auditor Jim Nobles announced he wanted to investigate the troubles at MNsure, and state officials said a division of Minnetonka-based UnitedHealth Group had been brought in to conduct a review of information technology problems. Many of the problems were delineated in a letter from Gov. Mark Dayton to IBM in December, which highlighted 21 specific issues, including a “black hole” where 1,100 applications for coverage were lost.

In late December, MNsure officials said that some consumers who couldn’t close the deal on coverage through the health exchange might want to consider buying policies directly from insurance companies.

The operational challenges were seized on by both Republicans and DFLers during Thursday’s meeting.

“We are left with a whole set of questions, just about how we’re going to get out of the position that we’re in today,” said Lourey, who carried legislation last year in the state Senate to create MNsure.

Insurance agents and a new group of advisers called “navigators” have had to put in countless hours of extra work trying to help consumers handle MNsure troubles, Lourey said. In addition, state workers in the Department of Human Services had to manually process thousands of applications in late December to make sure people had coverage starting Jan. 1.

“It’s just not sustainable,” Lourey said.

The challenges for MNsure are real, Leitz responded, but there are hopeful signs.

Previously, about 20 percent of MNsure users were running into troubles when trying to determine whether they qualified for a public health insurance program or a federal tax credit to discount premium costs, Leitz said. Now, only about 2 percent of users are having those problems, he said.

The problem with the application “black hole” has been largely resolved, Leitz said, and contingency plans involving paper applications should help MNsure handle an expected surge in applications in March.

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

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