The state’s MNsure insurance exchange launched open enrollment Wednesday without the early problems that plagued it last year, when technical difficulties struck the website and the call center was overwhelmed by alleged “robocallers.”

There were no signs of either of those woes this time, and complaints were muted at MNsure’s Facebook page, which has served in past years as ground zero for customer-service problems.

While the operational problems receded, broader questions remained in Minnesota and across the country about whether insurance markets under the federal Affordable Care Act will get smaller during the coming sign-up period, considering diminished support for the health law at the federal level.

“There’s a great deal of uncertainty about the future, which gives people a little bit of an excuse to put it off,” said Gary Claxton of the California-based Kaiser Family Foundation. “We even had a tweet [Wednesday] from the president about getting rid of the individual requirement … that’s one of the reasons why people come to get insurance.”

Minnesota launched the MNsure exchange in 2014 to implement the Affordable Care Act (ACA), which requires almost all Americans to have health insurance or pay a tax penalty. MNsure is an option for people in the individual market, which primarily serves people under age 65 who are self-employed or don’t get health insurance from their employer.

About now 166,000 Minnesotans buy individual coverage in Minnesota. Insurers in the state on Wednesday said it was too soon in the open enrollment period to characterize demand for 2018 coverage.

The number of people buying through MNsure has been growing to the point that just more than half of all individual policies in Minnesota are now sold through the exchange. But the broader individual market has shrunk considerably over the past three years due to big premium jumps, reduced competition among insurers and tight limits on the choice of in-network doctors and hospitals within individual market health plans.

Open enrollment at MNsure started at 8 a.m. on Wednesday and will last until Jan. 14 for people in Minnesota buying coverage for 2018.

“As of late [Wednesday] afternoon, received over 40,000 visits, had over 7,500 visits to the plan comparison tool and the contact center fielded nearly 3,000 calls,” exchange officials said in a statement. “Throughout the day, call wait times … continued to average one second.”

Whereas the federal government has cut spending on advertising and health insurance “navigators” to help people enroll in coverage, MNsure says it is maintaining funds for outreach efforts during the enrollment period. At Health Access MN, a navigator group with offices in St. Paul and Rochester, there were plenty of people on Wednesday signing up for coverage, said Sarah Greenfield, the group’s operations and policy manager in St. Paul.

“We’re seeing a similar uptick compared with the start of other open enrollments,” Greenfield said. She added: “People are not seeming as rushed or as panicked as last year,” since there wasn’t the same pressure as last year for people to buy before insurers hit caps on their enrollment.

As of 5 p.m. Wednesday, about 10 visitors had posted a mix of complaints and praise to MNsure’s page on Facebook. By the same time last year, more than 60 comments had been posted — primarily angry shots at MNsure about long waits at the health exchange call center and complaints about website problems, including 30 minutes of downtime at midday.

Dan Buck, 46, of St. Paul, was one of those complaining last year, writing on Facebook that he waited nearly three hours for phone help. But on Wednesday morning, Buck took to social media to announce he’d enrolled in just nine minutes.

“Last year was a total nightmare scenario,” Buck wrote in an e-mail to the Star Tribune. “This year was easy.”

Two MNsure users took to Facebook to complain they couldn’t use the website’s self-service process to change plans for next year. In an e-mail to the Star Tribune, website user Maureen Cuthbert of Lakeville said: “Suffice it to say that I could have done all of it myself, if the website was working correctly.”

In a statement, MNsure said it had “a few kinks right out of the gate,” but quickly fixed the issue with changing plans.

“We know of fewer than five cases where this occurred,” MNsure officials said. “Overall this was our smoothest open enrollment launch ever and we haven’t been seeing any widespread issues.”

Of the 166,000 Minnesotans covered by individual policies in April, more than half — nearly 95,000 — were obtaining insurance at the time via MNsure, while the remainder bought directly from health insurers.

Currently, 65 percent of people enrolled in private health plans through MNsure qualify for tax credits, with average savings for a household at more than $7,000 per year. This year, an individual earning up to $48,240 a year, or a family of four earning up to $98,400 a year could qualify for subsidies.

At Bloomington-based HealthPartners, officials said enrollment was going smoothly on Wednesday, but cautioned it will be weeks before the insurer has a sense for how demand compares with last year. At the LeClair Group, an insurance agency based in Woodbury, chief executive Richard Lett said it was “business as normal” with people signing up for coverage.

At Minnetonka-based Medica, spokesman Greg Bury said via e-mail: “What we know is that we’re busy, the phones are ringing, people are choosing/buying plans.”

Last year, Gov. Mark Dayton made the allegation about robocallers during the first day of open enrollment, and his administration subsequently asked the FBI to review the case.

Asked about the matter last month, an FBI spokesman referred the Star Tribune to a previous statement declining to say whether there was an active investigation.


Twitter: @chrissnowbeck