State targeting 'crisis need' cases in MNsure

The state launched a new help line option Friday for county workers when assisting people whose cases are hung up in the MNsure information technology system.

For more than a year, counties have complained about problems with the portion of MNsure they use to manage cases in public health insurance programs.

There have been improvements, but county workers remain frustrated in cases where coverage can't be established for people with crisis health care needs, said Nicole Names, the human services director for Pope County.

Counties want a "process to immediately assist our MNsure clients who are reporting their crisis needs to us," Names said during a MNsure board meeting Tuesday in St. Paul.

MNsure board member Lucinda Jesson responded by saying the Department of Human Services would be launching the new option, which she described as a sort of "911 line" for county workers. It's a new option within an existing help line that routes county workers to the front of the queue when assisting people with emergency health needs.

"You don't wait in line, you go to the head," said Jesson, who is also the state's human services commissioner.

Minnesota launched the MNsure exchange in 2013 to implement the federal Affordable Care Act, which requires almost all Americans to have health insurance. People use the system to purchase commercial insurance, and enroll in the state's public health insurance programs.

In January, a Washington County official told the MNsure board that MNsure remains "woefully inadequate" for managing such cases, and said county workers were at a "tipping point."

In April, a Scott County official highlighted good things about the MNsure system, saying the majority of people seeking public health insurance can sign up with relative ease.

But on Tuesday, Names described how county workers feel helpless when trying to help people with immediate health needs.

"When you have a mom in your office with a sick child, or a sick adult maybe, and they need a medication," Names told the board. "They can't go buy a medication because it shows they aren't current on their coverage, and so they come to us."

"The rub gets to be then — we try to call in, and the help desk is so busy," she said.

The dilemma confronting county workers points to two lingering problems with the MNsure information technology, said MNsure board member Phil Norrgard.

The MNsure system struggles to determine coverage for families where parents and children qualify for different assistance programs, Norrgard said. In addition, making changes to enrollee information within the MNsure system is time consuming, resulting in a backlog of changes that haven't yet been made.

"We don't have those things fixed yet," Norrgard said.

Overall, the MNsure system is doing a good job with eligibility for public health insurance programs, Jesson said, and more cases are going through quickly. But in complicated cases, there are problems.

"The good part is that you have so many more people enrolled in public assistance programs, and we're really able to help a lot more people now," Norrgard said during the board meeting. "The hard part is, we have remaining, persistent and difficult IT issues that you have to struggle with."