MNsure health insurance exchange busy, but still bumpy

Dave Berge knows himself pretty well, so he was surprised when the MNsure online health exchange wouldn't log him in because he couldn't answer four questions about himself.

"It was the pet insurance question," Berge said. " 'We see you've purchased pet insurance in the past. What was the name of the pet?' I've never had a pet!"

Frustrations with identity verification were among the complaints that emerged as Minnesotans started logging on to the MNsure health insurance exchange, a new online marketplace that launched Tuesday as part of the federal health care law. But volume remained high. By early Wednesday afternoon, more than 2,500 accounts had been created, though no data was given for how many people bought insurance.

The call center had received 425 calls by 2 p.m., and the website was seeing 2,000 to 3,000 users at a time.

MNsure executive director April Todd-Malmlov has acknowledged "a few bumps in the road," including a server crash shortly after the site went live, but said MNsure's IT crew was tracking issues and "fixing them as they come up."

After overcoming eight crashes and restarts of the MNsure application system, Rajean Moone was excited to find a plan with both lower premiums and deductions. A back injury left the 35-year-old from Minneapolis with limited and expensive insurance options until now.

"I didn't select the plan yet," said Moone, whose doctorate is in health policy. "I wanted to think more about it."

One issue was that while the site provided the premiums and other details, it doesn't yet tell consumers whether their doctors are included in the networks of the health plans they are considering.

MNsure leaders have said for several months that the provider-search feature is part of a series of planned upgrades, though they haven't given a specific date. They say the site also will be one of the few in the nation to provide quality data about doctors, hospitals and clinics, another feature that will come later.

Sen. Michelle Benson, R-Ham Lake, said she has heard from frustrated consumers who experienced problems and brokers who are still waiting for a direct portal to sign up clients through MNsure.

"I didn't expect a home run, but what they kept saying was that it was going to be terrific," said Benson, a member of a legislative panel overseeing MNsure, and a critic of Obamacare and MNsure's high price tag.

"They put the cart before the horse," she said. "If you're not ready to roll out, let's don't do a big advertising campaign. Let's do a quiet rollout … and let the brokers and counties test things and help us figure out the headaches."

Robert Krughoff of Consumers' Checkbook is concerned that MNsure and many other exchange sites around the country haven't done enough to make the shopping experience easy.

His organization has spent 34 years developing tools to help federal employees pick among hundreds of plans and has worked with several state exchanges, including Minnesota's.

Having a directory of doctors is essential, Krughoff said. Nevada's exchange has one, and Massachusetts added that feature in the past year. MNsure also lacks a way for consumers to get a full out-of-pocket cost estimate, something that is in the works in Colorado and would go a long way to help consumers work their way through what Krughoff described as a "mind boggling" numbers of choices.

"It's very hard to weigh those dramatically different premiums against deductibles and out-of-pocket costs," Krughoff said. "It should be on the front page, made very evident … People are left to do that entirely on their own on the MNsure website."

Issues for insurers

Scott Keefer, a vice president at Blue Cross and Blue Shield of Minnesota, said he and other insurers are worried about the "hand off" from MNsure. Consumers are starting to call Blue Cross, saying they have signed up for policies using the MNsure website. But Blue Cross won't get its list of new enrollees until Oct. 15, Keefer said, so it can't effectively answer questions.

"We knew this would be messy," Keefer said, "and it's not meant to point fingers. But the system as a whole is a lot clunkier than people thought."

MNsure offers 141 health plans offered by familiar Minnesota brands such as Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, PreferredOne and UCare. Some offer low deductibles but high premiums. Others offer low premiums but limited networks.

Minnesotans who tried the site on its first full day said they were aware they might experience start-up problems, but tried anyway because they were eager to get health insurance secured.

Some reported being surprised to find premiums that were more expensive than the plans they could already find in the marketplace. But experts said that is partly because the new plans are required to have richer benefits. Insurers also can no long exclude people based on prior medical history and can't place caps on lifetime or annual benefit amounts.

'Day of history'

Others simply wanted to be a part of the first-day launch of one of Obamacare's signature initiatives — even though benefits purchased in the MNsure site won't kick in until Jan. 1.

"Because of my complicated medical issues, I want to have everything dotted and ready to go," said David Wagner, 38, of Minneapolis, who is seeking better insurance to cover treatment of his cystic fibrosis. Part-time work at a medical staffing company leaves him without workplace coverage.

"It's also a day of history in my eyes," he added.

After two hours on Tuesday night, Berge gave up trying to enroll under his name when MNsure demanded that he identify which California high school he attended. "I went to Southwest High School, in Minneapolis," he exclaimed.

He successfully got by the security questions using his wife's information, but then the system froze Wednesday morning when he started entering family tax deductions.

"The website was definitely not ready for prime time," he said. "I wonder when it will be."

jeremy.olson@startribune.com 612-673-7744 jackie.crosby@startribune.com 612-673-7335