It’s early on a Monday, and Comopsia Stanley is making a series of calls in rapid succession, stopping only to wipe tears from her reddened eyes.
Her diabetic son, Demarco, 11, is down to just a day’s supply of insulin, and Stanley is trying desperately to determine if her online application for Medical Assistance through MNsure has been approved so she can buy more.
Each call is more frantic than the last. “What do you want?” Stanley, 36, pleads with an Anoka County social service worker. “Do you want my son to die?”
The messy rollout of MNsure, the state’s troubled online insurance exchange, just got messier for thousands of low-income Minnesotans.
Until December, families who qualified for Medical Assistance, the state’s version of Medicaid, could get immediate coverage by applying on paper at their local county social service offices.
That changed abruptly on Jan. 1, when new eligibility requirements prompted many counties across the state to stop taking paper applications for Medical Assistance. Instead, officials are directing poorer people to apply online through MNsure, a system that has been plagued with glitches since it went live in October. Paper applications are still accepted in some counties and at the Department of Human Services office in St. Paul.
While much of the attention has fallen on consumers using MNsure to buy commercial coverage from insurers such as Blue Cross, the glitches now mean potentially painful delays for thousands of poor Minnesotans who have urgent — even life-or-death — medical needs.
County officials say applications through MNsure continue to get stuck in computer limbo because of so-called “processing errors,” leaving people who are least able to afford medical expenses stranded with no insurance.
“If someone walks into a county agency looking for help, and is told to apply [through MNsure], that person is at risk of getting lost in the new system,” said Ralonda Mason, a supervising attorney for Mid-Minnesota Legal Aid in St. Cloud, which is assisting people with MNsure.
Advocates such as Mason argue that low-income Minnesotans should still get the option of applying for Medical Assistance on paper, as they have done for decades, until the glitches in the new online exchange are worked out.
“How many people are falling through the cracks because of this?” Mason asked.
In government circles, it’s a well-known secret that many Minnesota counties continued to process Medical Assistance applications the old-fashioned way — namely, by paper — even after MNsure went live in October. The MNsure website was prone to sudden crashes and processing errors, and the Medical Assistance applications were inherently difficult to process because of Minnesota’s complex eligibility requirements.
Since October, Anoka County has processed 4,500 applications for Medical Assistance using paper, with applications taken by hand and entered manually into the state’s old computer system — known as “MAXIS.”
“We knew that MNsure wasn’t ready for prime time,” said Jerry Vitzthum, director of economic assistance at Anoka County Human Services. “Why would we send someone into that system if we didn’t have to?”
The counties’ strategy helped alleviate some of the burden on MNsure by diverting applications away from the online portal. Enrollment in Medical Assistance through MNsure totaled 28,401 as of Jan. 4, more than double the 12,240 projected for the open enrollment period, which ends March 31.
One reason counties were reluctant to embrace MNsure is that many government workers recall an earlier botched effort at automating public health insurance enrollment.
In 2002, the state Department of Human Services embarked on an ambitious project to create an online eligibility system for nearly 700,000 people covered by the state’s public health programs. Known as “Healthmatch,” the project consistently failed to meet scheduled benchmarks and was millions of dollars over budget. The state finally pulled the plug on Healthmatch in 2009, after spending more than $40 million.
“There are workers around here who still remember Healthmatch,” said Heidi Welsch, director of family support and assistance for Olmsted County, which includes Rochester. “They remember that this was tried before and aborted because it was just too difficult.”
County workers, who are on the front lines of enrolling Minnesotans into public health care programs, quickly realized that their fears were justified.
Many people who applied for Medical Assistance through MNsure found that their cases disappeared into the system’s now-infamous “black hole” and were irretrievably lost. The system was also prone to crashing unexpectedly, making it difficult for people to determine if they had insurance. Vitzthum of Anoka County estimates that MNsure was inoperable “one-third of the time” in December, before improvements took hold.
“There are a lot of people who are stuck, and there’s nothing we can do to unstick them,” Welsch said. “It’s frustrating.”
Among those stuck is Mary Hierlinger, 57, of Anoka, who applied for Medical Assistance through MNsure in late December and is still waiting to find out if her application has been approved.
With a recent diabetes diagnosis, Hierlinger needs an answer soon. She has enough insulin to last the rest of this month but has no insurance and no way of paying for the medication after January. Hierlinger was laid off in October from her job as an inspector at an ammunition factory in Anoka.
“I’m in limbo,” Hierlinger said. “I don’t know what I’m going to do after January, but I refuse to live on the street.”
As of late Tuesday, Comopsia Stanley had grown increasingly desperate — and angry. The Fridley resident had just learned that her MNsure application was held up because she had to prove she was receiving unemployment insurance.
Her son was down to his last dose of insulin. Without insulin, he runs the risk of going into a diabetic coma, Stanley said.
“I’m in panic mode,” Stanley said, as she drove with her husband to the Anoka County Social Services office in Blaine. “At least give me coverage so I can get my baby some insulin. It’s life or death now.”