New MNsure leader promises fixes

MNsure's new chief executive officer promised Wednesday to do "everything in his power" to improve the online health exchange that has suffered from technical glitches, an understaffed help line and political miscalculations.

Scott Leitz, who has been the state's assistant commissioner of human services since 2011, started work just five days before a key enrollment deadline for Jan. 1 benefits. The exchange's previous leader resigned Tuesday amid criticism that many people are unable to sign up for plans on the website or reach anyone by phone who can help them.

"To those Minnesotans who have had problems, we apologize for that," Leitz said at a news conference before a meeting of MNsure's board. "But we are committed 100 percent … to making this process a better one for people."

New sign-up figures showed progress for the exchange, which the state created under the federal Affordable Care Act to cover the state's uninsured and improve benefit options for sick and self-employed residents. More than 47,753 applications for insurance covering 97,573 people were completed via MNsure as of Dec. 14, compared with 32,209 applications as of Nov. 30.

Lingering access problems

But those numbers are tiny compared with the exchange's aim to eventually serve 1 million Minnesotans, about one in five residents. People who want coverage continue to complain that they have been unable to get it.

"My husband has spent literally hour upon hour on the phone over the past few months, and is still not able to get in [to the website]," said Lori Nieters, 50, of Minneapolis, in an e-mail to the Star Tribune. "There were password problems. Every single time, they give him a new password and tell him it will work in a couple of hours. Still isn't working. He is beyond frustrated and has no idea what to do."

Leitz said MNsure enacted a new procedure Wednesday to identify people whose applications are stuck in the MNsure system and to try to get them enrolled by Monday's deadline. MNsure workers have also called roughly 1,000 people who are having to reapply for benefits because the initial determinations were wrong about whether they qualified for public health insurance plans or tax subsidies to lower the costs of private plans on the MNsure site. They were identified after a review of 30,000 applications that had been filed by Thanksgiving.

Leitz got the job after the resignation of former executive director April Todd-Malmlov, who received criticism for the exchange's problems and for taking a tropical vacation in November as MNsure was facing a new round of technical glitches. Hiccups with the website, which started with problems in October over security questions to allow people to create accounts, continued Monday, when the site was down briefly, and Tuesday morning, when it couldn't accept new applications.

Despite the problems, MNsure continues to see rapid increases in enrollment. Nearly 39,000 people had not only applied for coverage on MNsure but had taken the next step of selecting public or private health plans on the exchange and setting up online or mail-in payment. That included 11,805 people who enrolled in private market plans, bringing the state exchange closer to its goal of 69,904 enrollees in private plans by the end of open enrollment March 31.

"We're almost halfway through the six-month open enrollment process, and I'm very pleased we continue to see momentum," said Brian Beutner, MNsure's board chairman. "Our ultimate goal is to generate coverage for all Minnesotans."

Board members still fretted Wednesday that while more than 11,000 people enrolled in private plans on MNsure, more than 50,000 had applied but not selected coverage. That included 20,107 people eligible for tax credits to lower the cost of their premiums.

A focus on 2014 coverage

MNsure and insurance officials say the focus now is on making sure people who have tried to enroll for coverage will have it Jan. 1 — even if the process isn't complete.

Medica, UCare and Blue Cross and Blue Shield told the Star Tribune on Wednesday that they would work with state officials to extend the deadline by which consumers need to pay their premiums until Jan 10.

The MNsure board said it would consider postponing Monday's enrollment deadline as well.

Lakeville businessman Dan Silver said he has a solution for Minnesotans struggling to access benefits: "Forget MNsure." He helped his son, two employees and his business partner's brother sign up for private individual health plans without using the exchange.

"We did it," he said in an interview, "and it took less than 10 minutes."

Beutner encouraged people to do that, because many insurers offer the same plans outside of the exchange but only if they know they won't qualify for state Medical Assistance or MinnesotaCare programs, or for tax credits to lower the costs of private plans through MNsure. Subsidies are available on a sliding scale for a family of four, for example, that earns up to $94,200.

In some cases, people fully enrolled through MNsure will hit Jan. 1 without insurance cards. Eileen Smith of the Minnesota Council of Health Plans said that insurers will be coming out with guidance should they need to use their benefits before their cards arrive.

In other cases, people stuck with incomplete MNsure applications might not receive benefits at the start of 2014. Leitz acknowledged that MNsure's new review process won't catch everyone who is stuck and that the organization will need to figure out what to do when people who tried as hard as possible to enroll by the deadline were unsuccessful.

"That's a very real scenario that we need to address," he said.

Leitz's appointment as CEO is an interim move while the board searches nationally.

As an assistant commissioner for the Minnesota Department of Health, Leitz was a key figure in implementing then-Gov. Tim Pawlenty's 2008 health care reform package that included some ideas that were later mimicked in federal health reform.

He then took an executive role with Children's Hospitals and Clinics of Minnesota before returning to state government at the start of Gov. Mark Dayton's administration as an assistant commissioner of the Department of Human Services.

Jeremy Olson • 612-673-7744