Project leaders chose to launch Minnesota's health insurance website knowing it was plagued by bugs. Managers and auditors said for months that the project was falling woefully behind and that critical system tests came too late or had to be curtailed
Twelve days before Minnesota unveiled its $100 million health insurance exchange known as MNsure, a grim meeting was held at Gov. Mark Dayton’s residence in St. Paul.
April Todd-Malmlov, who had led the project, delivered a warning to the governor and his top advisers: No one was certain the new website built to help thousands of uninsured Minnesotans get health coverage would actually work.
The number of computer bugs in the system had recently surged from 237 to 270. And one-third of them were so severe that no stopgap fixes were possible.
The warning was one of many to surface in a hurried rollout that led to frequent website crashes and ongoing errors that have angered thousands of would-be enrollees, a Star Tribune examination of internal project reports, external audits and hundreds of state government e-mails show.
Managers and auditors said for months that the project was falling woefully behind and that critical system tests came too late or had to be curtailed. Among the Star Tribune’s findings:
• Auditors revealed dozens of major problems that were not fixed before the website was launched, state records show, contradicting public statements from MNsure officials that such issues were being handled promptly. Last July, for instance, auditors noted the MNsure website wouldn’t work with some Internet browsers, an issue that lingered through December.
• MNsure didn’t have plans to address website failures, forcing officials to scramble when the system broke down, state records and e-mails show.
• MNsure board members said they were not told about critical audit findings, and were unaware of meetings during which staff members discussed postponing the launch.
• Minnesota officials, who said the federal government’s Oct. 1 deadline to launch the website was “inflexible,” did not know that online enrollment could be postponed without penalty, an option federal officials disclosed in response to Star Tribune inquiries.
Minnesota’s only legal obligation on Oct. 1 was to make sure residents could buy coverage from the insurers who were participating in the exchange, according to the Centers for Medicare and Medicaid Services. That could have been accomplished through paper applications.
“I lament that I didn’t ask the simple question: Do we really have to do all of this by Oct. 1?” said MNsure Board Member Thompson Aderinkomi. “I should have asked.”
MNsure officials acknowledge the rollout has been difficult, but they note the agency has signed up more than 175,000 people as of Friday, well above a conservative projection of 135,000 in mid-October. They also said the agency has aggressively addressed technical problems and boosted staff where needed, including in MNsure’s understaffed call center.
Still, problems with the website continue to bedevil the agency, which will spend the next several months retroactively enrolling thousands who couldn’t get insurance online last week because of delays at the state and federal level.
The messy aftermath of the state health exchange’s troubled start also looms as an election-year issue for Dayton and other DFLers, as critics question why the online exchange was launched with so many unresolved problems.
For months last year, Todd-Malmlov had reassured the governor and MNsure board members that no serious obstacles would impede the launch. Dayton said her blunt alarm about the problems plaguing the site “came as a shock” during the Sept. 19 meeting at his residence.
“We didn’t have a Plan B,” Dayton recalled during a recent interview, adding that he “strongly urged them to fix the problems.”
Dayton said he was reassured in the days that followed that MNsure’s website would be “good enough to go,” but he left the final call to Todd-Malmlov, a health care policy specialist who served as MNsure’s executive director.
Todd-Malmlov, in her first interview since resigning under pressure in December, said the decision to launch was made jointly with Lucinda Jesson, commissioner of the Minnesota Department of Human Services. Todd-Malmlov said she also consulted with the governor’s office and top officials at MN-IT, Minnesota’s technology department.