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MNsure falls short of another enrollment goal

ST. PAUL -- Minnesota's health insurance exchange fell short of another enrollment goal this year, though MNsure's user experience appeared to be greatly improved from its rocky 2013 debut.

ST. PAUL - Minnesota’s health insurance exchange fell short of another enrollment goal this year, though MNsure’s user experience appeared to be greatly improved from its rocky 2013 debut.
Just over 60,000 people signed up for individual health insurance plans on MNsure in its 2015 open enrollment period, which ran from Nov. 15 to Feb. 15.
That was below the target of 67,000 that MNsure’s board set in December, and far below the original target of 100,000 enrollees.
The number probably will rise. People who already were in line for insurance at Sunday’s deadline can finish applying this week. People who have to pay a tax penalty for not having health insurance last year also can sign up for MNsure insurance for two months starting March 1.
Although plenty of low-income people have successfully used MNsure to sign up for the state’s public health programs such as Medical Assistance, it’s failed to attract many middle-income customers with commercial coverage offered by private insurance companies. People earning up to 400 percent of the federal poverty line can buy subsidized insurance on MNsure, while people earning more can shop for unsubsidized insurance.
In 2014, MNsure signed up about 47,000 customers for commercial coverage. That was well short of its projection of almost 70,000 by March 31, 2014 - a target the exchange has yet to reach a year later.
The 2014 open enrollment period was marred by well-publicized technological issues, including a website that crashed if too many people logged on at once and phone help lines that often kept people waiting for half an hour or more.
Those setbacks, and the organizational dysfunction that contributed to them, were detailed in a critical audit released Tuesday by the Minnesota Office of the Legislative Auditor.
Many but not all of those issues were improved for this year. The website still had issues, and some of the behind-the-scenes technology didn’t work at all. But the average wait time at the help line was just three minutes - down from 34 minutes last year, MNsure executive director Scott Leitz said.
But the improvement in technology came alongside another headache for many returning MNsure customers. Last year’s biggest commercial insurer, PreferredOne, didn’t sell plans in the exchange. Since 59 percent of MNsure customers had PreferredOne plans, that meant many had to either leave the exchange - and any tax subsidies they were eligible for - or switch insurance providers.
Since PreferredOne had won that market share with cheaper plans than many competitors, that also meant many MNsure customers saw premium increases.
With PreferredOne gone, Blue Cross Blue Shield expanded to the dominant market position. It had 43 percent of customers, plus another 7.3 percent through its BluePlus affiliate. Another 24.2 percent bought HealthPartners insurance, and 20 percent had UCare coverage.
Compared with last year, more MNsure customers bought less-comprehensive plans. While more than a quarter of 2014 customers bought “platinum” plans that cover 90 percent of health costs, this year just 7 percent did.
All this will hurt MNsure’s budget because the exchange skims a fee from commercial plans to fund its operations. Leitz didn’t know what the precise impact would be, but said officials are expecting it to be minor and won’t require extra money from the state budget.
MNsure remains in the political cross hairs. Republicans have consistently opposed it and are calling for major reforms. They had their hand bolstered by Tuesday’s audit, which concluded that MNsure’s “failures outweighed its accomplishments” in its first year and called to change how MNsure’s executive director is appointed and possibly revise its board of directors.
Democratic-Farmer-Labor Party members generally defend MNsure, but DFL lawmakers are also backing less-drastic reforms of their own.
So far, MNsure’s board isn’t taking a position on reforms that could see that board abolished or turned into an advisory body. But at a public meeting Wednesday, members agreed they need to come up with a position - and fast.
“We could say it is up to the Legislature, and in the end it will be,” said board member Tom Forsythe. “We may not even be here. However, while we are here, this is entirely our responsibility. … I think we should have a clear view of what should be the next best step for this organization and for its partners.”
The Pioneer Press is a media partner with Forum News Service.

Related Topics: HEALTH
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