ST. PAUL - MNsure is about to get its report card, and the results might not be pretty.
The embattled health care exchange endured high-profile tech problems and struggled to sign people up for private plans in its first year, though it did help hundreds of thousands of people find health insurance.
Today, that first year comes under the microscope with the release of a detailed investigation from the Legislature’s nonpartisan auditing office.
What that report will conclude is unknown, but even MNsure’s defenders expect it to examine some of the program’s failures. They simply hope it includes “constructive” suggestions on how to make MNsure better.
“A lot of it we’ve probably seen a bit about already, highlighted in the press,” said Sen. Tony Lourey, DFL-Kerrick. “But we’ll have more insights into what happened and how, and what might have made it better, or to stem some losses and maybe make it not as bad as it might have been.”
Republicans have been critical both of MNsure’s concept and its management. Tuesday’s audit might give some of them a chance to gloat, but Rep. Joe Hoppe, R-Chaska, said he’s looking for ways to improve MNsure, too.
“I was not a supporter of Obamacare or MNsure, but it’s the law of the land,” Hoppe said. “I hope that there are things in there that are either easily correctible.”
A MNsure spokesman declined to comment about the audit Monday.
The audit has been ongoing since last June. The Minnesota Office of Legislative Audit will look at three main areas:
• How good MNsure has been at helping people find health coverage.
• How effective MNsure’s leadership and board has been at running it.
• How choices made in MNsure compare to other states.
MNsure is an online marketplace created under the federal Affordable Care Act. It allows individuals to shop for private health insurance and receive income-based tax subsidies for it. MNsure’s website is also the vehicle for enrolling people eligible in Minnesota’s public health programs for low-income people: MinnesotaCare and Medical Assistance, or Medicaid.
The state has enrolled far fewer people on private plans than projected. That means a higher percentage on the public plans, which are more expensive for the state of Minnesota.
In 2013 when legislators created MNsure, supporters cited projections of 1.3 million people enrolling by 2016. The projection anticipated about 452,000 people would obtain private coverage through the state exchange by 2016.
Last year, MNsure lowered its projections for 2015 private enrollment from 100,000 to 67,000. As of Friday, a few days before the Feb. 15 deadline, just 49,238 people had enrolled in private plans.
The private plans are important to the future of the system because MNsure will fund future operations by withholding up to 3.5 percent of the value of premiums for commercial policies sold on the exchange. If such enrollments fall far enough below targets, it could impact its ability to make budget.
Hoppe said he’s concerned about that problem, but believes part of it might be due to overly optimistic projections. Before MNsure began, Minnesota had a much lower uninsured rate than the rest of the country.
Despite these shortcomings, the number of uninsured Minnesotans has fallen since MNsure’s debut.
Lawmakers are also eagerly awaiting the audit’s verdict on MNsure’s management.
Both Republicans and Democratic-Farmer-Labor Party lawmakers have proposed reforms to MNsure this year. It currently has an unorthodox structure as a quasi-governmental organization with its own board.
Lourey is backing a proposal to transform MNsure into a typical state agency. Hoppe said Republicans are open to a more drastic fix: eliminating MNsure and letting the federal government run Minnesota’s health insurance exchange.
MNsure private enrollment lags behind expectations
At the end of the 2014 open enrollment period, MNsure had enrolled fewer people on private plans than expected.
• For private plans, it projected 69,904 individuals and signed up 42,265.
• For public plans, it projected 56,324 people and signed up 163,654.
• Near the end of this year’s open enrollment period, MNsure is still trailing its projections for private plans.
• For private plans in 2015, it projected to enroll 67,000 people by Feb. 15. As of Feb. 13, it had signed up 49,238.
• Projections for public plan signups through MNsure were not immediately available.
The Pioneer Press is a media partner of Forum News Service.
