A key piece of President Obama’s health care overhaul came to life for Minnesotans Tuesday with the launch of the state’s MNsure insurance exchange.
As new online marketplaces went live across the country, technical glitches, slowdowns and delays were common. MNsure didn’t achieve liftoff until a little after 3 p.m., after last-minute testing of a connection with a federal hub.
Within the first hour, more than 500 accounts were created, but MNsure officials couldn’t say whether anyone bought policies. A server that helped consumers set up accounts went down early on, which spawned griping on social media from some frustrated users.
But MNsure executive director April Todd-Malmlov, who made the final keystrokes to launch the exchange, said it mostly handled the volume, which registered as many as 3,000 people at one time.
“We know there have been a few bumps in the road for us and for the federal government,” Todd-Malmlov said in an early evening news conference. “But we are tracking those, addressing them and fixing them as they come up.”
The exchanges are designed to enable consumers and small businesses to easily compare elements of various health plans and choose coverage based on their needs. While most people will continue to get insurance through an employer, more than 900,000 Minnesotans are expected to use MNsure in its first year.
Minnesota is one of 16 states, as well as the District of Columbia, that built their own exchanges. More than 30 states are relying on a model built by the federal government, which was felled Tuesday by heavy volume.
There were other problems elsewhere. Maryland’s state-run exchange announced a four-hour enrollment delay, citing technical problems less than 10 minutes after the system was scheduled to begin signing up uninsured residents.
Speaking at the White House just after 1 p.m., Obama said that more than a million people had visited the federal site by 7 a.m., more than five times the traffic on Medicare’s website. He said his administration would fix technical problems and adjust to “this demand that exceeds anything that we had expected.”
In Minnesota, some consumers expressed frustration that they couldn’t search by physician, a feature that the website promises will be available in the future. Physician and provider information can be found by going directly to an individual insurance carrier’s site.
For now, the enrollment section of the website will go dark every night between 10 p.m. and 6 a.m., generally mirroring the schedule for the federal hub, which confirms citizenship, income and other details necessary to determine eligibility for subsidies and public health plans. That time also will be used for maintenance and to prepare for future enhancements.
Delays in training and background checks temporarily stymied efforts of some 5,000 brokers and “navigators” to sign people up for coverage.
Portico HealthNet was still waiting Tuesday afternoon for MNsure to provide certification numbers that its 15 navigators need before they can help low-income individuals and families access health benefits on the exchange.
The Planned Parenthood chapter serving Minnesota has been reaching out for weeks to uninsured women and telling them they would get a call back on Oct. 1 to get enrolled in health plans. About 75 percent of its patient population is uninsured, officials said.
On Tuesday, its team of five navigators couldn’t sign them up for health plans, but called them anyway just to check in.
“We felt it was important to get back to people, given that it was the day of,” said Jennifer Aulwes, a local Planned Parenthood spokeswoman.
The MNsure site requires users to answer a few questions, such as their age or whether they smoke, and then quickly presents a list of coverage options. Social Security numbers and other personal data are required as a security measure to insure identities and to help people with financial assistance.
Plans are rated from the least-expensive “bronze” offerings to premium “platinum” plans.
Jeff Fowler, who owns a Minneapolis brokerage agency, urged consumers to take a close look and weigh the options. In general, low premiums come with higher out-of-pocket costs and fewer options for hospitals or doctors.
“On some of lower priced plans, they’re almost exclusively with a certain care organization,” he said. “If premium is the boss, you can get the rates pretty low and with subsidies even lower.”
Waiting to enroll
Marla Hovde is so eager to get insurance through MNsure that she attended a UCare informational session on it last week.
Hovde has been unemployed and uninsured for two years. An insurer denied her coverage because of a chronic illness, so instead she has been burning through her savings and paying $160 out of pocket for doctor visits every two months to check her blood levels and receive refills of a blood thinner and a cholesterol medication.
But she opted to stay off the site Tuesday after hearing about potential start-up problems.
“I figured it’s the first day,” said Hovde, 56, of Woodbury. “If there are any kinks, let them get those worked out.”
While Tuesday’s launch was a milestone, MNsure officials offered reminders that it was merely the start of a six-month open enrollment period to buy coverage starting Jan. 1.
For those who want coverage to become effective on Jan. 1, they will need to purchase by Dec. 15, insurance companies say.
University of Minnesota professor Larry Jacobs has spent the past year hosting monthly forums on health reform efforts with national and local leaders. He compared Tuesday’s nationwide rollout of exchanges to other significant social programs, such as Social Security and Medicare, which underwent decades of funding, government foot-dragging and congressional changes.
“In the big picture, these problem we’re seeing are more overload problems rather than about programs not working,” Jacobs said. “If we’ve still got these problems in a month or two, or the federal hub isn’t working, I’d be concerned.”
The New York Times contributed to this report.
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