Sign-up 'navigators' are helping to ease MNsure headaches

Soothing saxophone tones filled the conference room at Portico Healthnet in St. Paul on a recent morning — not from the PA system, but from the speaker of a mobile phone on hold with MNsure. "Your total wait time may be in excess of 30 minutes," said the message. "We apologize for any inconvenience …"

Chuckles filled the room, but the delay was no laughing matter. With a key deadline looming and the MNsure health insurance website still experiencing technical glitches, agencies that help Minnesotans find a health plan have shifted into high gear.

On Saturday, Portico had turned to a classroom approach, with six adults working on laptops as four helpers looked over their shoulders. "We simply were running out of time and people power to do the one-on-one enrollments," said Rebecca Lozano, a Portico outreach manager.

Trained helpers known as "navigators" were always envisioned as a key enrollment strategy for MNsure, with many of them coming from social service agencies, like Portico, that work with poor and uninsured Minnesotans. But as frustrated consumers continue to struggle with the MNsure website or wait on hold for its overwhelmed hot line, navigators are emerging as even more important lifelines.

Saturday's event started at 8:30 a.m. and was filled until 5:30 p.m. with people who needed 60 to 90 minutes to sign up for health insurance, hoping they could be enrolled before Dec. 31 and have coverage on Jan 1.

Taichi and Robin Chen of New Hope had completed an online application but needed help to enroll themselves and their daughter in a plan.

"We're just trying to bring it home," Robin Chen said.

Gregory Collins of Maplewood lost his insurance benefits when he was laid off from a foundry this summer. His son has been without epilepsy medication all school year. When he tried to drop a completed paper application at the front desk of the Minnesota Department of Human Services, he was told it wouldn't be processed in time and that he should consult a navigator.

Nearby was a St. Paul woman named Cherie — too embarrassed by her struggles with MNsure to give her last name — who lost her health benefits after a divorce and has been uninsured for a decade. The 63-year-old woman said she hasn't qualified for public Medical Assistance coverage in the past, and that when she got really sick, she went to a Walgreens clinic and paid for care herself.

Cherie squinted at the text on her screen, then raised her hand, muttering, "It's the craziest thing ever" until a Portico helper was available.

"It's asking me, 'Do you plan to make Minnesota your home?' " she said. "Well, I've already made it my home. Do I press yes?"

Many enrolled, many frustrated

It's unclear how much navigators have boosted MNsure enrollments so far; many didn't start their outreach efforts until mid- to late October because navigators had their own set of delays in training and certification.

While assistance from a navigator is noted on an enrollment record, a MNsure spokeswoman said last week that she did not have data showing how many enrollments were completed with their help. Nor does MNsure have payment figures; navigators are paid $25 to $70 per enrollee, but payments to the agencies aren't scheduled until next month.

As of Dec. 14, some 38,955 Minnesotans used MNsure to enroll in health plans — 11,805 in private coverage and the rest in public programs such as Medical Assistance.

But MNsure leaders have been vexed by 50,000 people who completed applications and qualified for private plans — and in some cases for financial subsidies for their premiums — but then didn't select one.

Some might have shopped but decided coverage was too expensive. Others might have experienced technical problems on the website that blocked their enrollments, or they delayed their selections until the last moment. (While Dec. 31 is the deadline for Jan. 1 benefits, Minnesotans can wait until March 31 to select plans for 2014 and not suffer financial penalties for being uninsured under the federal Affordable Care Act.)

Like winning the lottery

The day at Portico reflected the variety of consumer experiences to date.

While Collins made progress in his application, an elderly man next to him couldn't log in, and a woman across from him was locked out of the site because of incorrect password attempts.

Lozano celebrated as Collins reached the Web page where he could pick a plan.

"It's like a personal victory every time you get to the next step," she said.

"Fist pump!" Collins replied.

Cherie was the first in the morning group to enroll.

"It's like a weight off my shoulders," she exclaimed. "I can't wait to go home and tell my kids it actually worked!"

Collins came next. He hesitated to discuss his success for fear that it would jinx the application. While his wife is insured through work, it was too expensive to add him and their 19-year-old daughter and 11-year-old son with epilepsy.

MNsure's option was much more affordable, he said.

"I feel like I just won the $6 million lottery," he said as his application completed.

Jeremy Olson • 612-673-7744