Hennepin County officials say they must hire 92 people to handle the workload as 41,000 residents with public health insurance coverage move into the MNsure IT system.
In a letter this week to Gov. Mark Dayton, County Board Chairwoman Jan Callison says the requirement for moving enrollees into the system, plus new eligibility checks that are being mandated by the state, will force the county to add staff to work in a MNsure system that’s inefficient and requires “onerous workarounds.”
At a meeting Tuesday, the Hennepin County Board delayed action on the proposed hiring. If it goes forward at a meeting scheduled for June, the county would tap about $3 million in federal and state funds to cover most of the staffing costs, plus another $1.7 million in county spending.
“Our county taxpayers should not be required to pay yet even more for an ineffective system we do not manage or control,” Callison wrote.
The complaints from Hennepin County are the latest in a long series of frustrations from counties statewide about the portion of MNsure they use for people in the Medical Assistance health insurance program. This portion of MNsure is now called the Minnesota Eligibility Technology System (METS).
“We urge that you take action to correct the METS systemic inefficiencies and provide financial support to manage this crisis now — this session,” Callison wrote. “The financial obligations that Hennepin County is being forced to impose on … property taxpayers are unnecessary and burdensome.”
Dayton spokesman Matt Swenson said Friday that the governor takes the concerns seriously, and has directed state officials to work with counties to improve the technology.
The governor is “concerned by the operations of the MNsure system,” Swenson said in the statement, but he also cited “additional burdens placed upon counties last session by the Republicans” through the requirement for periodic checks on eligibility.
Rep. Matt Dean, R-Dellwood, said the eligibility checks are needed given audit reports that have suggested many in the public programs have coverage when they don’t qualify. Dean called it “shocking” that Hennepin County would need so many extra workers.
“If there’s anything that tells that this thing is broken, to the point of irretrievably broken, this is it,” he said.
MNsure is the name for Minnesota’s health insurance exchange, which is an online marketplace for private coverage that’s part of the federal Affordable Care Act.
While all states have access to a government-run exchange like MNsure, Minnesota in 2013 opted to develop a new eligibility and enrollment system for Medical Assistance as part of its exchange. The program is the state’s version of Medicaid, which provides coverage for several groups of state residents, including Minnesotans living near or below the poverty line.
Counties administer Medical Assistance in conjunction with the state Department of Human Services (DHS). In a statement, the department said it is working with counties to move about 280,000 Medical Assistance cases from an old computer system into the new one, starting in July.
A majority of Medical Assistance cases already are in the MNsure/METS system, but the transition has taken much longer than expected because of technical problems. Once the transition starts, it must be completed within a year to maintain federal funding, DHS says.
Since the MNsure system was launched for 2014, county workers have struggled to efficiently use it to manage cases for enrollees. The state has made improvements, but county workers have been frustrated by the pace of changes, said Deborah Huskins, an area director for human services at Hennepin County.
“Counties are pretty weary,” Huskins said. “The staff, in particular, are frustrated that there’s not more improvement, faster.”
The new system must perform tasks not required of the old one, DHS says, including real-time eligibility determinations based on instantaneous checks of a federal data hub. The agency says the MNsure/METS system “continues to evolve as system functionality is improved.”
“This has resulted in both manual workarounds and an ongoing need for workers to maintain and update their knowledge of system functionality and procedures,” the DHS said.
The transition of 280,000 people involves county workers taking new applications from people currently covered by the program, said Marti Fischbach, the director of employment and economic assistance for Dakota County.
If enrollees apply through the MNsure website, the applications sometimes lead to coverage without troubles, Fischbach said. In other cases, county workers must intervene because of snags with electronic applications, she said, and workers are always involved with the slow process of handling paper applications.
“Overall, we all feel the same pain that Hennepin feels,” Fischbach said. “It’s going to be quite labor intensive.”