While more than 12,000 Minnesotans have created MNsure accounts, fewer than one-third of those have completed enrollment in health plans, state officials said Wednesday.
The meager sales figures didn't alarm MNsure officials — not when Minnesotans still have two months to secure coverage for the start of 2014. But they do reflect the turbulent first two weeks of an online health insurance marketplace that aspires to extend health benefits to as many of the state's 490,000 uninsured residents as possible.
Since the MNsure website was launched Oct. 1 as part of federal health reforms, accounts have been created by 12,011 people — some with chronic illnesses and a desperate need for health insurance. Only 5,569 of those have finished applications, with 3,769 enrolling in various plans. And only 406 have completed the purchase of private plans on the site; most were eligible for public programs such as Medicaid.
MNsure Executive Director April Todd-Malmlov said that the early figures were ahead of her expectations and that she expects that procrastinating enrollees will sign up before the Dec. 15 deadline for coverage on Jan. 1.
"Even during employer open-enrollment periods, most people enroll in the last two days before the open enrollment period ends," she said.
The gap between accounts created and health plans purchased so far may reflect the number of people who have just been "window shopping," as MNsure spokesman John Reich put it, and who need time to make the weighty decision of buying insurance.
But it also reflects a website and an enrollment system that have suffered "a hiccup or two."
Problems with security verification early on prevented half of the people who visited MNsure from creating accounts. Now, MNsure reports that more than nine of 10 people are successful, but that other glitches have needed fixes and that certain Web browsers are causing headaches.
"It's only going to get better," Reich said at a MNsure public forum Tuesday night.
Mitch Grussing of St. Paul told the board Wednesday that he "got the impression that the site wasn't really even done yet" when he tried and failed to sign up on the first day.
The 27-year-old was successful on the second day, though. Private insurers had denied him affordable coverage in the past, he said, because he has obsessive compulsive disorder and takes a routine generic medication.
"It's done its job," he said, "at least for me."
For others, start-up problems were enough to turn them away.
Sharon Anderson logged on to MNsure last week because her small business, GMI Travel of Minneapolis, urgently needs a new health plan. The company was dropped by its current insurer, apparently because all six employees are women in their 40s, Anderson said in an interview last week.
"We're six healthy women. None of us smoke. And nobody wants us. It's frustrating."
A first attempt at creating an account was successful, and Anderson uploaded her employees and started shopping for health plans. But she could never get back to that point, and she finally gave up after confronting too many error messages.
"At this point, I need a broker," she said. "I'm just frantic."
MNsure was created as a state exchange under the federal Affordable Care Act, often called Obamacare, largely to provide health coverage to the state's uninsured.
Todd-Malmlov said the state conservatively expects 135,153 new enrollments of individuals, families and small businesses by the time open enrollment for 2014 closes on March 31. Another 60,000 enrollments are expected later in the year as people change jobs or experience other life-changing events that allow them to buy coverage.
Julie Rasmussen of St. Louis Park had no trouble logging on and shopping for plans, but said she needed more time to compare their costs and benefits. Rasmussen, 57, likely will remain on her employer plan, but she is shopping for her husband, who has a disability and raises her current premiums. "I pay a phenomenal amount to cover my husband," she said. "It's almost a quarter of my income."
Lauren Fithian, 55, of Minneapolis, also wants a better deal on health coverage but still can't get by MNsure's security questions and register for an account.
"I got the same nonsensical questions today that I got yesterday and all the days before," she said in an interview.
MNsure board members said Wednesday that the site's problems were in line with what they expected, given the rushed rollout of an ambitious website that connects with a variety of federal data sets to determine premiums for enrollees and whether they are eligible for discounts or subsidies.
However, they encouraged MNsure staff to continue to improve it.
"When you're talking about IT," said board member Thomas Forsythe, "user experience rules."
Efforts to assist MNsure users in person also have been slow to develop. Trained helpers, called navigators, couldn't assist users right away because of delays in their training and certification.
Security concerns still prevent brokers from accessing MNsure in a way that allows the brokers to complete enrollment for the customers remotely.
And, technically, nobody has fully completed enrollment for a plan on MNsure yet, because the state is behind schedule on turning over enrollment applications to the insurers providing the plans.
While Todd-Malmlov said the plans will get information soon, the delay was fodder for Republican legislators opposed to Obamacare in general and Minnesota's decision to invest in its own exchange.
"The longer MNsure remains in disarray, the fewer people will actually get insurance," said Rep. Tara Mack, R-Apple Valley.
A looming concern is whether MNsure will meet its revenue goals, because the exchange is funded by withholding a percentage of premium dollars paid to insurers. With premium amounts coming in lower than expected in Minnesota, the exchange will need plenty of enrollees to cover costs.
MNsure officials remained optimistic.
Joel Martinez, a navigator with Portico Healthnet who is certified to help people select plans, said there is a lot of enthusiasm from the people coming to his office.
He isn't surprised that many have applied but haven't bought plans. Many need time to wade through the personal security questions, then have to go back and talk with family before selecting plans with deductibles as wide ranging as $1,000 to $10,000.
"They are pretty excited," he said, "to enroll as soon as possible."