One trouble after another plagued MNsure, the state's health insurance exchange, when it debuted last year.
People struggled with the website. Calls for help led to hourlong waits. Advisers who were supposed to help people use the new system instead felt thwarted by it.
Ultimately, the turmoil forced the departure of MNsure's executive director and stoked a partisan debate — even as more than 350,000 Minnesotans connected with coverage.
This week, as MNsure opens enrollment again, state officials are touting system improvements while also cautioning that everything still may not work perfectly — a tricky mix of messages that reflects the high stakes.
"Last year, there was a lot of business that went directly to the health plans, because MNsure was in such trouble," said Stephen Parente, a health finance expert at the University of Minnesota. "This is the year to see whether MNsure is going to live up to its promise of really being the marketplace for private health insurance."
In a last-minute scramble to avoid a repeat of troubles, state officials are pushing a series of website fixes and final contingency plans designed to make sure consumers have a better experience. At the same time, they're trying to broadcast the message that if consumers don't give the exchange another shot, many could lose out financially.
MNsure has a financial interest as well, since the exchange must eventually pay for itself. MNsure keeps a small percentage of the premiums on commercial policies sold through the exchange.
Minnesota launched the online marketplace in October 2013 to implement the federal Affordable Care Act, which requires almost all Americans to have health insurance or pay a tax penalty. The exchange is an option for state residents who buy insurance as individuals, rather than as part of employer groups or government programs such as Medicare.