Wednesday marks a "new day" for thousands of Minnesotans who acquired health insurance through MNsure — whether they know it or not.

While many Minnesotans are enjoying the certainty of coverage they obtained through the state's online insurance exchange for 2014, others reached the stroke of midnight Tuesday night with no clue whether their enrollments had been completed or whether they have medical benefits today.

As of late last week, more than 50,000 people had completed applications to buy private health plans on MNsure but had not completed enrollment — leaving their status in health insurance limbo.

In some cases, technical problems with the MNsure site prevented them from finishing their enrollment. MNsure's Facebook page was cluttered Tuesday with exasperated people who couldn't get the online exchange to work ahead of Tuesday's deadline and couldn't reach anyone on the telephone hot line.

"3½ hours on hold," wrote Amanda Rutherford of Crystal around noon Tuesday. "Unfortunately, I have to now hang up without resolution because I'm off of work. And start ALL over …"

"I've been trying for TWELVE DAYS to get access to my locked account," wrote Matthew Ostman, 28, of St. Michael. "No e-mails answer, no success getting through on the phone."

"Why oh why do you hate us so much, MN Sure?" lamented Jamie Ward, 29, of East Bethel.

MNsure officials have apologized for the problems with their ambitious start-up exchange — launched this fall under the federal Affordable Care Act to improve insurance options for the sick and uninsured in Minnesota — and sought to extend benefits to anyone who has made a good-faith effort to enroll. While consumers still have until March 31 to buy coverage in the open-enrollment period, state officials pressed to enroll as many people as possible by the end of 2013 so they would have benefits immediately at the start of 2014.

"Our aim is to get everyone into health insurance coverage on January 1st who wants it on January 1st," said Scott Leitz, MNsure's interim CEO, in an interview before Tuesday night's deadline. "If that means getting them through the system electronically, that's great. But if it also means working them through in a manual way so that we get them into initial coverage, we're doing that as well."

Consumers who have reached the stage of enrolling in plans and making initial payments will be covered, whether they have received cards from their insurance carriers or not, according to a MNsure tip sheet released Tuesday night.

The status of people with incomplete enrollments wasn't as clear. MNsure officials have been trying to secure timely benefits for people whose enrollments have been delayed by glitches in the application process. But the tip sheet indicated that MNsure "couldn't guarantee" Jan. 1 coverage for them.

Despite enrollment delays, doctors and other care providers are assuring patients that they will treat them first, then figure out if they have insurance to cover it second.

"If a patient needs to get taken care of, we're going to take care of that patient and worry about the [insurance] eligibility after the fact," said Dr. Cindy Firkins Smith, a dermatologist and president of the Minnesota Medical Association.

Retail pharmacy chains Walgreens and CVS Caremark also announced plans to fill prescriptions for customers who are uncertain whether they have obtained insurance coverage on the federal or state exchanges.

The great mystery

MNsure was created with the ultimate goal of covering the roughly 490,000 Minnesotans without insurance and improving benefits for people with illnesses or disabilities who have been denied affordable coverage by insurers in the past.

The state exchange started with more modest goals for 2014, though, including enrolling 69,904 people in private health plans by the March 31 open enrollment deadline and providing many of them with tax credits to lower their premium costs.

As of Dec. 27, some 19,420 people had enrolled via MNsure in private market plans.

The great mystery is why another 55,000 people have completed MNsure applications but haven't selected a plan and completed enrollment. Whether those people have turned away because of MNsure's technical problems, or have been delaying their purchases until the last minute, could determine whether or not the state will meet its enrollment target.

Nationally, more than 2.8 million Americans have enrolled in private insurance plans, either through state exchanges such as MNsure or by using the federal site at HealthCare.gov. The number falls short of the Obama administration's goal of 3.3 million by year's end, but U.S. Health and Human Services Secretary Kathleen Sebelius told reporters in a conference call Tuesday that the turn of the calendar year nonetheless marks "a new day" for millions of Americans "who have been locked out or priced out of insurance because of a pre-existing medical condition."

'Pending' status

In Minnesota, at least, part of the problem is people wanting to enroll but being unable to do so. Some have had applications on MNsure listed as "pending" for weeks or even months since MNsure was launched in October.

Jamie Ward says her application has been in process for most of December. Her infant son already has state Medical Assistance coverage, her older son is supposed to qualify for the program as well, and she and her husband are both supposed to receive tax credits to buy private plans. But error messages on the MNsure website prevented her from buying a policy, and now she doesn't really know who is covered and who isn't.

In the land of frostbite, flu bugs and icy falls, that isn't a very comforting thought.

"I worry, especially with it being winter," Ward said. "What if somebody falls and breaks a leg? You just don't know."

Amanda Rutherford likewise knows she has until March 31 to enroll, but needs coverage immediately for herself and three kids. Her husband is covered by his workplace health plan. Checkups and immunizations have already been scheduled for the children this month. And Rutherford is hoping to finally get photo therapy treatments for the psoriasis that both she and her 6-year-old son suffer from.

So after three hours on hold Tuesday morning, Rutherford returned home from her job and spent another three hours on hold in the afternoon. Twice she reached a live person at MNsure who put her back on hold.

"My application was submitted on Oct. 2," she exclaimed. "It's said 'pending' ever since!"

Star Tribune staff writer Jackie Crosby contributed to this report. Jeremy Olson • 612-673-7744