Accountability is needed for confidence in exchange and government.
Guides worked the phones on Dec. 31, 2013, in St. Paul, Minn. for shoppers scrambling to finalize health coverage before the new year at Minnesota's insurance marketplace. The call center was the fallback for health insurance shoppers vexed by the troubled MNsure website.
Dayton probably isn’t the only Minnesotan who’s lost sleep over the launch. Website problems have delayed or denied many who have tried to sign up for health insurance through the state exchange.
Minnesotans deserve answers to the many questions being raised about the botched rollout. To that end, the state’s legislative auditor, a legislative oversight committee and MNsure’s board of directors all have begun separate examinations of MNsure. The three reviews are essential in order to hold public officials and vendors accountable — and to restore credibility in the exchange and state government.
MNsure officials, as well as the vendors involved in implementing the state exchange, should fully cooperate with these efforts. But the burgeoning controversy cannot become an excuse for MNsure. Its mission must remain to provide Minnesotans access to health insurance.
In the meantime, state residents should have full faith that the Office of the Legislative Auditor will deliver an accurate, impartial and thorough analysis of the website’s problems. Jim Nobles, who is serving his sixth six-year term as legislative auditor, has the impeccable credentials and broad bipartisan support needed to determine what went wrong.
Regardless of the performance of the website, Nobles’ office would have examined the program because of the $155 million in federal funding that MNsure has received since February 2011. But the auditor’s review will dig much deeper and include an analysis of MNsure’s governance, especially the role the board of directors has played. Appropriately, Nobles also will look at the performance of the Dayton administration.
Dayton told an editorial writer that he has “great respect” for Nobles and welcomes the review. “I think it’s very important that all of us involved and the public get an accurate analysis of what’s occurred with MNsure,” he said.
Despite not directly overseeing MNsure, the governor is deeply involved. On Dec. 13, he sent a sharply worded letter to the CEO of IBM with a specific list of unresolved issues. Dayton was right to use his office to get a high-level, immediate response. But when the letter became public, it appeared to many Minnesotans that MNsure’s problems were mostly due to poor performance by outside contractors. Instead, news reports and information discussed Thursday at a legislative hearing revealed that MNsure pushed its lead technology vendor aside and assumed responsibility for constructing the website and technical infrastructure last February. Today, by concept and contract, MNsure is ultimately responsible to make the exchange work.
Within MNsure, the “end-to-end” review announced by interim CEO Scott Leitz should spare no part of the organization — including the board itself. If there was not enough oversight and guidance of former CEO April Todd-Malmlov, or not enough pressure put on vendors chosen to implement the system, the board should hold itself accountable and make immediate changes. Leitz already has taken the positive step of getting an immediate outside analysis from Optum, a UnitedHealth Group data services subsidiary that previously did troubleshooting for the federal site, HealthCare.gov, as well as for Maryland’s state exchange.
The legislative oversight process is important, too. But it should focus on the governance and performance of MNsure and not devolve into a partisan attack or defense of the federal Affordable Care Act. Obamacare opponents have made their views known, and will no doubt make the rollout debacle a key campaign issue in 2014. But the ACA is law; MNsure is here to stay, and Minnesotans need government to perform.
The troubled rollout of MNsure, and what that says about government’s competency, is especially important to Nobles, who has spent his career trying to build public trust in government. The longtime auditor told an editorial writer that he’s deeply concerned about the Minnesota exchange. “It’s one of the most important issues the state has faced, partly because the expectations were so high. We were trying to address a problem that was long-standing. We kind of fumbled when the stakes were so high, and we did it in front of the world. And the people who really suffered were the citizens.”
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