MNsure's fast enrollment pace continues, as shoppers apparently are focused on the chance that most health plan options could disappear vs. questions about the federal health law's future.

Since open enrollment in the state's individual market began on Nov. 1, nearly 24,000 people have signed up for private health plans through MNsure. That compares with fewer than 7,000 sign-ups at this time last year.

Shoppers have been scrambling because of enrollment caps that regulators granted most insurers as an emergency measure to help them prevent further financial losses.

The state launched MNsure three years ago as part of the federal Affordable Care Act, and the big enrollment numbers come despite questions about the future of the health law given electoral triumphs by Republicans.

"We have heard from assisters just anecdotally across the state that consumers are canceling their appointments because there is so much uncertainty out there right now about the Affordable Care Act," said Allison O'Toole, the MNsure chief executive, during a board meeting Wednesday in St. Paul. "My message to them is: Don't give up."

The MNsure exchange is an option for the roughly 250,000 state residents who buy health insurance on their own. The market serves about 5 percent of state residents and has experienced troubles that aren't being seen in the much-larger markets for employer-sponsored health plans and government programs like Medicare.

With 23,883 people signing up via MNsure for private coverage as of Nov. 13, the exchange is more than one-fourth of the way to its budget target of 83,000 enrollees at the beginning of next year.

About 38 percent of shoppers this year are in the age 55-to-64 bracket, up from about 33 percent last year. The numbers could suggest a lack of young and healthy enrollees in the market, but O'Toole said it's too early to draw conclusions.

Minnesota is unique in having enrollment caps for four of the five insurers that compete in the individual market. Last week, Minnetonka-based Medica was the first insurer to hit its enrollment cap, so the company's health plans aren't available to new customers in most cases.

O'Toole said that MNsure was able to quickly remove Medica as an option on its website.

"We were prepared for this, and things from an operational standpoint when very smoothly," she said.

Greg Bury, a spokesman for Medica, agreed with the assessment.

Current Medica enrollees in the individual market still have the right to renew their policies, even though the cap has been hit.

Republicans who expanded power in Washington D.C. with this month's elections have vowed to repeal and replace the Affordable Care Act. In St. Paul, Republicans who expanded power in the state Legislature have talked about abolishing MNsure, as well.

MNsure didn't provide numbers on exactly how many Minnesotans have canceled appointments due to concerns over the health law, and O'Toole stressed that Minnesota insurance advisers, in general, have been very busy. She said she raised the issue to reassure consumers that "there have been no changes in the law," telling reporters that she's heard lawmakers say they don't want to cause disruptions.

Federal officials have described a postelection effect that went in the other direction, with a surge of people buying coverage on the federal government's website, which serves as the exchange for most states.

For the first time on Wednesday, MNsure released market share numbers for the four health insurers selling through the exchange for 2017.

Medica has been the most popular health plan choice thus far with 34.2 percent of the market, up from about 21 percent last year.

Minneapolis-based UCare also has seen its market share grow, with 27.5 percent of the MNsure enrollment for 2017.

Bloomington-based HealthPartners has seen its market share decline slightly to 25.6 percent, followed by a 12.8 percent share at Blue Plus, which is the HMO operated by Eagan-based Blue Cross and Blue Shield of Minnesota.

The Blue Plus share is up slightly from last year. Blue Cross, however, is dropping out of the individual market, where it now has about 20 percent of the MNsure market. The figures don't include sales in the "off-exchange" market, where insurers sell directly to shoppers.

Thus far during open enrollment, more than 60 percent of those who have signed up for private plans via MNsure are new to the exchange, O'Toole said. That's a higher share, she said, than at

MNsure is the only place for Minnesotans to tap federal tax credits.

So, it was expected that more state residents would use the exchange in hopes of offsetting 2017 premium spikes in the individual market.

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck