More than 500 people signed up through MNsure for commercial health insurance this past weekend, but the state's health exchange still has a long way to go to hit its enrollment target.
Currently, MNsure has about 50,000 enrollees in private health plans, and its budget projects the number will grow to just over 100,000 by the end of 2015.
A national expert on health exchanges called such an enrollment jump for MNsure in the near term a "tall order," and MNsure chief executive Scott Leitz last week suggested the target could be revised.
On Monday, as Leitz announced that MNsure recorded 518 commercial enrollments during the first weekend of open enrollment, he said it's too soon to evaluate MNsure's progress on enrollment numbers.
"What we saw last year was that about 60 percent of our enrollment came through … [during] the last days of March," Leitz said, referring to the close of the first open-enrollment period at MNsure.
The exchange's second open-enrollment period started Saturday and lasts until Feb. 15. People seeking commercial coverage for January must purchase by Dec. 15.
"If last year's experience in terms of consumer behavior is [instructive], I think those will be the two dates that will be kind of key," Leitz said during a news conference Monday in St. Paul.
Minnesota launched MNsure in 2013 to implement the federal Affordable Care Act, which called for the creation of exchange marketplaces for all 50 states.
More than 27,000 new and returning users accessed the MNsure website over the weekend, Leitz said. As of 4 p.m. Monday, MNsure's call center had fielded 4,528 calls, and the average wait time was about 4 minutes.
"The website remained stable throughout the weekend," Leitz said. There were "no major glitches that we're aware of."
Commercial revenue key
In 2013, MNsure fell short of its goal for enrollment in commercial policies. This year, MNsure officials have talked about their commercial enrollment target in the context of the budget for the health exchange, which will be more reliant on revenue from commercial enrollees.
Currently, MNsure is withholding 1.5 percent of commercial premiums sold through the exchange for about $2.2 million in revenue. For 2015, the amount withheld — which some call a premium tax — is 3.5 percent. Assuming enrollment of 101,703 next year, the budget anticipates nearly $11.7 million in revenue from commercial premiums.
Revenue projections will be adjusted in December after MNsure gets updated information from the state Department of Human Services, said Joe Campbell, a MNsure spokesman. The department administers the Medicaid and MinnesotaCare programs and currently provides more MNsure revenue than commercial enrollees. Program beneficiaries enroll through the exchange.
All health exchanges across the country face challenges in drumming up consumer interest this fall, health policy experts say. During a forum Friday at the University of Minnesota, health care consultant Joel Ario noted that the federal government earlier in November cut its projections for growth through the exchanges.
"I think it is a tall order to get from 50,000 to 100,000," said Ario, who previously helped create exchanges for the U.S. Department of Health and Human Services. "I would probably say it's a goal for the next couple years, rather than a goal for the very next year."
MNsure has a particular challenge, because most who bought private coverage through the exchange for 2014 might find their policies aren't available in 2015 through MNsure. So, the exchange must convince those shoppers to come back to MNsure, rather than follow the path of least resistance — an automatic renewal outside the exchange.
While acknowledging the challenges, Leitz said during Friday's forum that MNsure has some things going in its favor. Premiums will be higher in 2015, so more Minnesotans should qualify for tax credits that discount premium costs, Leitz said. Those subsidies are available only through MNsure.
When asked about the 100,000 target, Leitz said: "We're going to try like heck to get there. … But I also want to be clear that we're going to be taking a look at that and see whether we need to make revisions."