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Health Care Reform:

Health Insurance & Affordable Care Act

Several Factors Hobbled MNsure From the Start

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But what went wrong in the first place? The paper trail shows many problems were evident early on.

Not Focused On Technology

The Affordable Care Act, which authorized Minnesota and other states to build an insurance marketplace, had barely been on the books for five months in the fall of 2010 when then- Republican Gov. Tim Pawlenty effectively rejected a $1 million planning grant.

When Gov. Mark Dayton, a Democrat, took office in 2011 he charged ahead, in part by setting up an exchange task force.

Problems, though, were already taking root.

The group wasn't thinking deeply enough about the technological nuts and bolts of the project, and the same was true of the state employees leading the effort, said task force member Dannette Coleman, chief for individual and family business for the Medica health plan.

"This is really a technology project," she said. "One of the challenges is the [MNsure] leadership viewed this from a health policy standpoint and not from an IT technology implementation standpoint, and I think that drove a lot of the challenges along the way."

Insurance company executives also complained that the Legislature denied the industry a seat on the agency's board over concerns about a conflict of interest, so tough questions about the site's technological infrastructure weren't asked early or frequently enough.

When MNsure went live, its technical flaws emerged quickly. Some people were locked out of their applications, while others struggled to find out if they were eligible for financial assistance. MNsure didn't run well on certain web browsers, and many users were confronted with frozen screens.

MNsure officials might have known about many of these problems if they had tested the site with consumers prior to Oct. 1.

But, as agency officials rushed to make their deadline, they say they didn't have time to do what IT consultant Michael Krigsman calls a cardinal rule of technology development.

Testing "is one of those things that's so foundational, it doesn't even deserve a 'Why?'" said Krigsman, who specializes in preventing IT projects from failing. "It's like, 'Why do we need to breathe the air?'"

Wed, Mar 12 2014

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