Other board members said they were surprised that they were never informed about the audits. “That is serious stuff,” said Peter Benner, MNsure’s vice chairman. “We clearly should have been told that.”
Todd-Malmlov said it never occurred to her that the board should see the consultants’ findings. “Are there things I would have done differently? Yeah, there are,” she said, declining to elaborate.
Todd-Malmlov and MNsure Chief Operating Officer Erik Larson said they believe they made the right decision to launch on Oct. 1, emphasizing that many website problems have been repaired.
“As hard as it has been on people in general — consumers, employees — I think it was the right thing,” Larson said. “We’re getting people through. We’re getting them enrolled.”
No fallback position
Reflecting on MNsure’s rocky rollout, Beutner said he is struck by the prevalence of “best-case scenario” planning.
“It required everything to go right,” he said.
But project managers were raising questions about contingency planning more than a year ago. In an e-mail from February 2013, a state IT specialist pointed out the “critical importance” of having someone come up with a backup plan. The issue was deferred.
Other states also failed to consider the worst. In Oregon, state officials were recently criticized in an audit for failing to come up with a “Plan B,” when it was obvious that Oregon’s insurance exchange website was not ready to launch.
Without a website, Oregon had to spend about $4 million to hire 400 temporary workers to process tens of thousands of paper applications. As of mid-March, Oregon was ahead of Minnesota enrollment by more than 28,000 people.
Minnesota officials never seriously considered processing a large number of paper applications, even though the state was supposed to offer that option, according to federal officials. Larson said the idea was dismissed as too expensive, but he acknowledged that the staff never analyzed the costs.
In the early weeks after MNsure’s debut, the agency had so little manpower for paper applications that it had to start rejecting many of them. Eventually, persistent problems with the website forced the agency to accept more than 25,000 paper applications. They had to be processed by Human Services staff.
Jesson said launching without a fallback was a mistake. “By November, that was one of my serious concerns. We had to make sure there were contingency plans that were not dependent on an IT fix.”
‘The ball got dropped’
Since January, MNsure’s website has improved significantly, but its error rate continues to hover around 5 percent. That is down from a high of 22 percent in October, though not much better than the federal exchange website when it was at its worst with a 6 percent error rate.
“The problems were bigger than we thought they were going to be,” said Chuck Johnson, a deputy commissioner at Human Services who was deeply involved in the project. “We had a plan, but we got overwhelmed by the problems that came after Oct. 1. … A lot of it is related to not having enough time for testing.”
Several state officials said they can’t understand why federal officials didn’t emphasize that online enrollment could be delayed back in January 2013, when Minnesota and other state officials were brought to Washington, D.C., and given 70 new requirements for their exchanges.
“We were having to do three years of work in a year and a half,” said Baden with MN-IT.