Worries about Minnesota's new online health insurance marketplace are keeping Gov. Mark Dayton awake at night.

The state has just three weeks to get the MNsure site ready for Jan. 1, when Minnesotans who have signed up will expect to begin using their new health insurance and the new federal requirements to carry health insurance or face a penalty start to take effect.

As many as one out of every five Minnesotans eventually may obtain their health insurance through MNsure, the state health exchange that is supposed to make shopping for health insurance cheaper and easier. But in the 2 ½ months since the MNsure website launched, it has been plagued by glitches, crashes and long waits for customer service.

"It is, in my mind, past the point where these kind of snags should have been resolved," Dayton told reporters Wednesday, shortly after telling a crowd at the Minnesota Association of Counties that MNsure worries have him tossing and turning at night. "I'm mindful of how complicated the project is, and that we're doing better than the federal government." But, he said, "we're three weeks away. I am concerned."

Dayton said he has "expressed my sense of urgency" to MNsure officials.

The time left is even shorter than it seems. To have a policy that takes effect on Jan. 1, Minnesotans are facing a Dec. 23 deadline.

By the end of November, 71,579 people had completed applications for MNsure coverage, but only about a third — 24,586 — had gone through the full process of picking out a plan and setting up payment. Some 48,724 sought coverage from private insurers, and the rest were applying for the state's public programs, MinnesotaCare and Medical Assistance.

Working round the clock

MNsure officials say they're doing their best to ensure that the governor, and anyone else shopping for health insurance, rests easy. But MNsure Board Chairman Brian Beutner says he can sympathize with Dayton's lack of sleep. "It keeps me up at night as well, and I know it does the MNsure team," Beutner said, "because I'm getting e-mails and phone calls from them at midnight because they're literally working around the clock."

The worst may be yet to come. Officials expect a rush of traffic in the run-up to the Dec. 23. deadline. Those who fail to sign up by then won't face penalties until March 31. At that point, if they remain uninsured, consumers will have to pay a penalty of $95 or 1 percent of taxable household income, whichever is greater.

The closer the enrollment deadline looms, the more people scramble to enroll, and the more MNsure scrambles to deal with the increased traffic.

Its website continues to bog down at peak times, and some people have been kicked off the site, mid-enrollment.

On Wednesday, the estimated wait time was 60 minutes to get through to the center.

The agency is more than doubling its 30-person call-center staff, with 27 new hires on the job and 15 more in training to report to work next week.

Officials on Wednesday said the agency is extending its hours. The website will now be available seven days a week, from 6 a.m. to midnight.

The call center will be open Monday through Friday from 7:30 a.m. to 8 p.m. MNsure officials say the downtime has been used to do system maintenance and upgrades and is tied to the hours in which the federal hub is available to verify eligibility for tax credits.

Meanwhile, MNsure still hasn't figured out how to properly hand off the enrollment data to the health insurance companies, sparking a letter of concern last week from a leader of the industry group that represents the state's largest health plans. In late November MNsure said it was double-checking 40,000 applications to determine whether people were being wrongly denied tax credits to reduce the cost of insurance or weren't being signed up for Medical Assistance or MinnesotaCare.

Julie Brunner, executive director of the Minnesota Council of Health Plans, said insurers are receiving inaccurate or incomplete data, including duplicate enrollments. She warned that there was a lack of time for consumers to make premium payments, and pushed responsibility back on MNsure to communicate with new enrollees.

For Republican opponents of the health exchange, the governor's remarks look like validation of their own fears.

"I'm glad he's finally realized that there is a problem," said House Minority Leader Kurt Daudt, R-Crown. "This is something that's been keeping us awake for a very long time."

Republicans stayed away from the task force that hammered out the MNsure framework and battled the bill on the floor.

Daudt said the party now is alarmed by reports of insurance companies that aren't getting needed paperwork and constituents who can't navigate the system.

"Maybe it's time to get together and solve the problem," he said. "We're happy to come to the table and try to clean up the mess. But first they have to admit that there is a mess."

jennifer.brooks@startribune.com • 651-925-5049

crosby@startribune.com • 612-673-7335