Health exchange website has to work better in ’15 than it did in ’14.
A recent Star Tribune story that took a deep dive into MNsure operations before its troubled Oct. 1 launch set off a new and understandable round of questions this week about the fledgling health insurance marketplace’s leadership, transparency and accountability.
The concerns raised by the April 6 story, one that relied on e-mails made available through the state’s Data Practices Act, merit the thorough “look back” analysis that both MNsure critics and advocates called for this week. However, the questions are also too important to be left in political hands. Looming fall elections mean elected officials’ priority is often scoring political points instead of taking a constructive look not only at what happened but at what needs to happen so that MNsure works better in 2015 than it did in 2014.
Any doubts about that were put to rest at a MNsure Legislative Oversight Committee meeting this week. The 10-member committee, which couldn’t find time to hold a full meeting during MNsure’s November and December troubles, is stacked with DFL cheerleaders and Republican rock throwers. The dysfunctional composition of the joint committee yielded too many politically self-serving questions and too few queries about a topic that sorely needs the spotlight: improvements that must be made before next fall so that the site better meets the expectations of consumers, insurers, and the brokers and “assisters” who provide customer guidance.
Fortunately, the state’s respected, independent Office of the Legislative Auditor is on the job. This week brought the welcome news that Jim Nobles’ office had won legislative approval to broaden its evaluation of MNsure’s rocky rollout. Nobles said this week that the findings would be released in December.
This wide-ranging, nonpartisan investigation should shed light on a key question raised by the story: Should the information about MNsure’s technical troubles available then have delayed its launch? While it’s clear that problems existed before the start date, the meltdown of core software from an IBM subsidiary didn’t start becoming apparent until deep into October. That raises another key question: Did this vendor provide adequate information about its product?
Answers are also needed about whether MNsure’s leadership adequately communicated information about the site’s troubles — both before and after the launch — to the marketplace’s board of directors, the legislative oversight committee and to Gov. Mark Dayton. Critics have long taken aim at MNsure for its lack of transparency. While interim CEO Scott Leitz has improved this, clearly there’s more work to be done. The auditor’s report should guide these efforts.
The practical improvements needed to ensure that 2015 open enrollment goes smoothly when it begins Nov. 15 must take top priority while the state waits for the auditor to complete the report.
Dayton unfortunately missed an opportunity this week to lead on this key issue. At a news conference, he blasted MNsure’s GOP critics, calling their latest round of questions about the launch a “farce.” The criticism muddied what should have been his main message: that MNsure’s top priority is finding forward-minded fixes. The website must run reliably next fall. Substantial operational and technical improvements are critical.
A timely letter from the state’s health insurers to Brian Beutner, the MNsure board chairman, underscored the need for a pragmatic focus. The April 8 letter from the Minnesota Council of Health Plans urges the board to make IT and operations its highest priority, with particular emphasis on making the site more user-friendly for brokers, counties and others assisting with enrollment.
Other key improvements highlighted included improving connectivity between MNsure and the state agency overseeing public health program enrollment. MNsure should also be able handle “life changes,” such as when a customer needs to add a new baby to a health plan.
The insurers’ letter received too little attention this week. But its plea to “give these issues the priority they deserve” should be heeded. MNsure has to operate reliably if it’s to live up to its promise — delivering quality, affordable health insurance. Despite the political divide over MNsure, that ought to be a goal that unites Minnesotans.
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