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Several Factors Hobbled MNsure From the Start

WebMD News from Kaiser Health News

By Elizabeth Stawicki

Wed, Mar 12 2014

By Catharine Richert, MPRNews

Using MNsure should have been easy for Becky Fink.

As a local clinic director, she'd been trained by the state’s new health insurance exchange on how to help people sign up online.

But the site never worked for her even though she "tried, tried, many, many times, many times."

It wasn't her fault.

Fink was among thousands of other Minnesotans who saw MNsure's cheery Paul Bunyan TV ads and tried to use the site once it went live in October. Some had success, but others are still trying to get insurance or have given up all together.

Behind MNsure's upbeat façade was a swamp of management failures and technical glitches that crippled the more-than $100 million website.

MNsure leaders blamed tight deadlines and evolving federal requirements for the website's malfunctions.

However, internal MNsure documents and interviews with insurance company officials, county workers and other stakeholders reveal a more complicated story.

People interviewed by MPR News say MNsure's top officials, including former executive director April Todd-Malmlov, were insular and stingy with information and that they ignored advice for improvement. They say MNsure staff was disorganized and often didn't have answers to their questions. And an early decision by the state to buy software that was still under development compounded the problems, adding to what one recent report called a "crisis mode" inside MNsure.

Moreover, the state never tested the website on consumers before it went live.

State officials had expected MNsure to enroll up to 1.3 million people for insurance by 2016, but a recent review by consulting firm Optum found MNsure is unlikely to meet those goals.

MNsure's new leadership says things are working better now and they are encouraging Minnesotans to select and purchase health coverage in the remaining weeks of open enrollment.

MNsure’s interim CEO Scott Leitz says things are working better now, thanks to 100 new staff members at its overloaded call center and fewer website errors.

"It's stable and it is in much better shape than it was in the fall and it's the best place for people to go," Leitz said.

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.

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