After two months of failure and hours of help from her broker, Toni Byard navigated Minnesota’s glitchy health insurance website, MNsure, and bought coverage on Tuesday.
“So much frustration!” the 63-year-old from Blaine. said “I just want to get back on a plan.”
Her experience mirrors the bigger picture reported by MNsure executives at their board meeting Wednesday.
After a nightmarish launch in October, the online exchange is connecting a rising number of sick, self-employed and uninsured Minnesotans to health insurance coverage.
More than 71,000 people applied for insurance on MNsure as of Nov. 30 — up from more than 31,000 at the end of October. Some 48,724 sought coverage from private insurers, and the rest were applying for the state’s public programs, MinnesotaCare and Medical Assistance.
“More than a doubling has occurred over the past month,” said April Todd-Malmlov, MNsure’s executive director.
Fewer have taken the next step — completing enrollment and selecting a payment method. That tally is now 24,586 — with the great majority eligible for public programs; only 4,478 people have enrolled in private individual plans.
But the process has not been without headaches, and the higher numbers still leave Minnesota short of its projection that at least 102,800 people would buy private health coverage on MNsure’s individual market for 2014.
That figure included more than 33,000 expected to buy coverage later in the year, after the open enrollment period. Minnesotans have until Dec. 23 to pick plans on the exchange for coverage to begin Jan. 1. They have until March 31 to purchase plans and avoid the financial penalty that was created under the federal Affordable Care Act, known as Obamacare, which also spawned the online insurance exchanges for consumers to buy policies.
Now, MNsure officials are turning to a new challenge: forwarding applications to the health insurers consumers chose, for enrollment and invoicing, a process that has started only recently and that has its own set of glitches. In some cases, MNsure didn’t provide complete or correct addresses for the enrollees, so insurers were unable to send those invoices as of Wednesday.
Once customers paying by mail receive the invoices, they will need to make payment quickly to guarantee coverage for the start of 2014, said Eileen Smith of the Minnesota Council of Health Plans, which represents insurers such as Medica, HealthPartners and Blue Cross and Blue Shield.
“Time is very crunched,” she said. “Consumers will not have the traditional 30 days to send their payment in full.’’
Quirks cause errors
Coverage by 2014 was all Byard wanted when she first attempted to log on to MNsure in early October. She found herself unable to get far because the website couldn’t verify her answers to security questions. Even this week, Byard and her insurance broker, Jeff Fowler, said they were getting error messages and technical problems on the website.
Byard lost her job in 2006, and then lost health coverage through her husband’s employer when he retired and enrolled in Medicare. She bought a monthly plan on the private market for 2013, but it wouldn’t cover care related to her pre-existing hypertension. For 2014, Byard selected a HealthPartners plan on MNsure and learned that she will receive tax credits to subsidize the cost of the premiums. But she was successful only because her broker took the illogical step of clicking a button indicating at first that Byard wasn’t eligible for subsidies.
Fowler, the broker, said MNsure officials need to be more forthright about their website’s problems.
“I think people deserve to know before they get closer to the [enrollment] deadline and to the holidays and all of the other stuff that goes on at this time of year that somebody has their backs,” he said.
MNsure officials recently acknowledged additional quirks that caused errors in determining whether applicants qualified for Medical Assistance and MinnesotaCare, or for tax credits toward private coverage. More than 30,000 applications are now being double-checked, although state officials believe that only a few will change. Todd-Malmlov said reviews should be completed this week.
People urged to apply online
At Wednesday’s board meeting, she also reported problems with the portion of the MNsure website used to enroll small businesses and delays in processing 1,603 individual applications that were submitted by mail. She encouraged people at this late point to enroll online.
Delayed handoffs from MNsure to state and county agencies also have slowed the enrollment of people who qualify for public programs. Some people seeking MinnesotaCare might act promptly but still not have premiums paid by January, said Lucinda Jesson, commissioner of the state Department of Human Services, which manages the program. The state is taking steps to make sure they have coverage in January, despite any enrollment delays.
“We’re not going to keep people from coverage because of that delay in MinnesotaCare,” she said.
Preparing for December rush
Despite the number of problems and “manual workarounds,” MNsure officials said they are prepared to handle a December rush of enrollments, as procrastinating Minnesotans turn to the site. Todd-Malmlov said MNsure has doubled its hot line staff to reduce wait times.
MNsure officials also gave an early peek at the demographics of enrollees: So far, nearly half of the people enrolled have been 51 or older. That raised concerns among MNsure board members because insurers also need younger enrollees to balance the “risk pool’’ by offsetting the higher medical costs of the older enrollees.
History suggests that younger, healthier enrollees will enroll closer to the deadline, Todd-Malmlov said. “You would anticipate the first ones in are the ones that know that they need insurance.”
John Grobe of Minnetonka is one satisfied customer, having found a plan in mid-October for his wife, who isn’t covered by his employer’s health plan. Grobe found a plan with a higher deductible but a premium that’s $3,700 per year cheaper than his wife’s current plan — and a network that included her doctor.
“It’s driving me nuts that everyone says that this is a loser program, that it doesn’t work,” he said. “I’m here to say it does.”