MNsure enrollments up, but getting data to insurers troublesome

MNsure reported progress Wednesday on hitting its enrollment goal for 2015, but an insurance industry official said the exchange still isn't getting workable information to health plans about those who are signing up.

A surge in enrollments over the past week means that nearly 24,000 have bought private policies for next year thus far, said Scott Leitz, the MNsure chief executive during a board meeting in St. Paul.

Leitz said he was encouraged by a report Wednesday from the Minnesota Department of Health that showed the uninsured rate for adults under the age of 65 was 6.7 percent in September — down from 10.7 percent last year.

But board members on Wednesday also heard discouraging words from Minneapolis-based UCare, a health insurer that expects to gain a significant amount of business through the exchange next year. MNsure still hasn't sent any workable electronic files to UCare about people signing up for coverage.

"This puts UCare and other health plans in an awkward position of responding to customer service calls from new members who are looking for member ID cards and other information — and we don't know who they are," said Joel Ulland, assistant director for legislative affairs at UCare.

"We were expecting our first set of files almost two weeks ago," Ulland said. "It puts a lot of pressure on our back-office operations to provide new enrollment materials for our members when the information is not coming in a timely fashion or is not accurate."

State officials said they are on the cusp of solving technical problems that have dogged the data transfer so far. Insurers are concerned because similar problems last year meant a lot of manual work by companies to get subscribers into coverage.

"It will be resolved like every other issue that's come up in the last 18 months," Beutner said. "It will get done."

Minnesota launched the MNsure exchange last year to implement the federal Affordable Care Act, which calls on almost all Americans to have health insurance or pay a tax penalty. The law promoted coverage by helping states expand their Medicaid health insurance programs for people with low incomes, and providing tax credits for many to buy private health insurance through exchanges.

The impact in Minnesota is documented by the new health department survey, which researchers said is consistent with a University of Minnesota study this June that found the state's uninsured rate dropped to 4.9 percent. The health department report provided a higher estimate for the uninsured rate, but that's because it didn't look at coverage for children and people age 65 and older — groups where coverage tends to be more expansive.

"If this new estimate included these groups … we estimate that the overall rate of uninsurance for all Minnesotans would be between 4 and 6 percent," the health department report states.

In a prepared statement, Dr. Ed Ehlinger, the state health commissioner, said the new study on the uninsured is important because expanded insurance coverage "not only helps people stay healthy, but saves money by potentially preventing more serious and costly health problems."

Health exchange officials have refused to say how many they think must enroll this month to hit the overall target. Saturday is the deadline for people to obtain coverage that starts in January, and open enrollment continues until Feb. 15. After that, people can enroll through MNsure only in special circumstances.

During the board meeting, Beutner said the latest enrollment numbers suggest that MNsure is "above plan," since there likely will be another 6,000 people who will automatically be renewed into MNsure policies at month's end.

Board member Tom Forsythe suggested that "on-plan" was a better description, to which Beutner said: "That's better than behind."

Enrollment in commercial insurance through MNsure is critical for the financial future of the exchange. MNsure must cover a larger share of its costs next year by withholding 3.5 percent of commercial premiums — an assessment that some call a premium tax.

Earlier this year, MNsure's budget assumed it would generate revenue from 100,000 commercial enrollees next year. But exchange officials had to reduce the figure by one-third after PreferredOne — currently the most popular choice among MNsure shoppers — announced it was dropping out of the government-run marketplace.

Board member Phil Norrgard said he supported the decision to extend the deadline as much as possible, but worried consumers might get confused. He added: "I feel a little bit disappointed that this seems to be an end-run."

Forsythe said he wanted to respond to the moves by insurers by challenging them to complete enrollments up until year's end for MNsure customers, too. But it's tough to issue that challenge, Forsythe said, when the health exchange still can't send accurate information about enrollees to the insurers.

"We can't actually hold their feet to the fire … because we can't get them accurate data," he said.

Christopher Snowbeck • 612-673-4744