Technical flaws persist within the MNsure exchange more than a year after its debut, and state officials said Wednesday that fixes may not be complete before open enrollment begins Nov. 15.
Officials remain hopeful that the website will be improved from last year, but tests could uncover new problems that can't be resolved before the deadline, said John Schadl, a spokesman for MN.IT. That would force MNsure to quickly implement contingency plans, such as returning to the one-on-one assistance to help connect people with coverage that it employed last year.
"This is going to be a high-risk project. And we are going to use that full runway up until the go-live date," Jesse Oman of MN.IT, the state's information technology agency, told the MNsure board at a meeting Wednesday.
A full update about the status of the information technology system is expected from MNsure officials next week, before thousands are expected to start using the health exchange to renew coverage and shop for new plans. But insurance agents said Wednesday they remain frustrated by the lack of answers.
"We are asking for complete and utter transparency today — assisters need to know what's coming," Alycia Riedl of the Minnesota Association of Health Underwriters told the board. "We don't know how the system is going to work."
Minnesota launched the MNsure health exchange last year to implement the federal Affordable Care Act, which requires almost all Americans to have health insurance. Board members Wednesday were focused on the update of MNsure's information technology system, because the balky health exchange website last year frustrated thousands of consumers who then endured hourlong waits from an overwhelmed call center.
The call center is one reason that MNsure officials say they are optimistic about the upcoming open enrollment period. Initially staffed by about 22 people last year, nearly 300 workers will be answering phones this time around, said Allison O'Toole, deputy director of external affairs at MNsure.
Whereas insurance agents and health insurance "navigators" were barely trained at the outset of open enrollment last year, MNsure this year has a much better network to help insurance shoppers, O'Toole said.
Still, the presentation from information technology officials was meant to provide a cautious assessment of where the MNsure website stands, Schadl said.
"We have a reasonable level of confidence that we're going to be able to clear those obstacles and have the code ready in 10 days," Schadl said in an interview following the board meeting. "But we also don't want to paint an unrealistically rosy picture, because we don't know that for sure right now."
Schadl said he did not want to describe exactly what backup plans are in the works if fixes to the software code don't work.
But where the state suspects things could go wrong, officials are "actively developing contingency plans to have a workaround to deal with it," he said.
"There are a couple of things we certainly learned from last year," Schadl said. "One is, it's not enough to just rely on the technology. … Last year, we really didn't have contingency planning in place."
Time running out
During Wednesday's meeting, board members said they sympathized with insurance agents and pressed IT officials to provide some way for consumer assisters to become familiar with the system before open enrollment starts. Board member Phil Norrgard picked up on Oman's analogy in describing the situation, and said: "If you use up the runway, that means there's less of a runway for our partners."
But Brian Keane with Deloitte — the consulting firm advising MNsure on website improvements — stressed the importance of continuing with the plan for testing and implementing website fixes. There are fewer than 10 "blockers" that IT officials are trying to tackle, Keane said, and some of those are critical to the website's performance.
"We need those days just to make sure we work through those," he said.
The information technology system isn't the only challenge facing MNsure. In September, Golden Valley-based PreferredOne announced it would not sell policies on the exchange for 2015, even though the company accounted for about 32,000 policies, or 60 percent of all commercial policies sold on the exchange this year.
All those PreferredOne customers will automatically be renewed into policies from the company that are sold "outside" the exchange. That's a problem for people who qualify for federal tax credits to discount their premium costs, since the only way to get a subsidy is to buy a policy on MNsure.
Brian Beutner, the MNsure board chairman, pushed MNsure staff Wednesday to make sure they communicate clearly with people about the situation, saying, "If they don't come to us, they're going to get screwed."
People who don't have coverage as part of an employer group can buy individual insurance policies through MNsure.
The system also determines whether people qualify for the state's public health insurance programs.
As of Nov. 4, nearly 370,000 people had enrolled in public and private insurance through the exchange. In the long run, plans call on MNsure to connect about 1.3 million Minnesotans with coverage.
Hitting the goal involves the transfer of more than 500,000 people already covered by public health insurance programs into the MNsure system. But board member Lucinda Jesson said Wednesday that the timeline for part of this transition is being delayed.
"This has been a challenging decision," said Jesson, the state's Human Services commissioner. "We're phasing folks into the new system, as the functionality improves."