Officials with Minnesota's online insurance marketplace have billed the MNsure website as a "one-stop shop" for health insurance similar to the travel website Travelocity with a strong resemblance to H&R Block.
State officials have said it will make shopping for health insurance easier, and for some people, provide less expensive insurance options.
When the state's $100 million online insurance marketplace finally launched earlier this month, consumers found that while it shares some of the same components as those well-known websites, it lacks important features — even though it was more than two years in the making.
MPR News went back into the archives to find five of the biggest promises MNsure officials made about the future site before its launch — and gauged whether they've delivered on them.
1. The exchange "needs to facilitate real-time eligibility and enrollment." - MNsure Executive Director April Todd-Malmlov, in remarks to the Senate Commerce Committee on Jan. 16, 2013.
When MNsure is working properly, the website partly lives up to this promise.
Users need to create an account to find out if they're eligible for government subsidies or government programs, and to enroll in a plan. The function is meant to streamline the process of getting insurance, and already, county workers say they're pleased that some Medical Assistance participants using the site have received instantaneous approval to be in the program.
But during MNsure's first two weeks, many people had trouble taking this basic — and necessary — step largely because of issues with a federal service used to verify that site users are who they say they are.
The malfunction has gotten progressively better since Oct 1, but some still haven't been able to create an account. Others tell MPR that they are having trouble enrolling on their Apple computers. And a bug in the system has prevented some people from paying for their plans.
It's also worth noting that while MA participants can find out if they're eligible for the program on MNsure, they won't be able to enroll in one of the Medicaid HMOs through the site until 2014.
In the meantime, the plan selection process is still done on paper.
Even when the MNsure site is functioning smoothly, the agency hasn't been able to deliver application data to insurers. Until insurers get that information, they can't finalize enrollments and issue insurance policies. MNsure official say they'll be able to send this information to the insurers by the end of the month.
2. "MNsure will provide quality ratings on plans and providers throughout the state." - MNsure informational video, March 21, 2013
As late as July 10 of this year, MNsure was touting its rating feature. In an informational webinar, MNsure Marketing and Communications Director Mary Sienko said it would be a "really fabulous" component of the site because people buying insurance on the exchange or elsewhere would be able to use it to find the best doctors and hospitals in the state.
"Say for example you have a child that has asthma," Sienko said. "You want to take that child to a clinic that has really good outcomes with asthma patients....You can go on to the quality ratings and see how a certain hospital or a certain clinic has been with their outcomes for asthma patients."
Later in the summer, Todd-Malmlov said quality ratings were on the backburner.
"It is not one of the functionalities that we need to do, it's something we want to do," Todd-Malmlov said in a Sept. 20, 2013 meeting.
The federal Affordable Care Act requires that state exchanges include health plan ratings, but they have three years to do it. MNsure officials say they'll have that information available next year. In addition, the website will include quality ratings for providers — a step beyond what the ACA requires.
3. "An exchange will provide comparative information in an apples-to-apples format." - MNsure Executive Director April Todd-Malmlov, Aug. 12, 2011, Commerce Department press release.
There's plenty of comparison shopping people can do on MNsure.
For instance, you can click on up to three plans to see how they stack-up in terms of deductibles, premiums and metal level.
But users have to dig deeper for the details. The site does allow consumers to make side-by-side comparisons of the detailed terms of plans, such as the coverage for durable medical equipment or emergency room visits. Those terms are available only by individual plan in a downloadable PDF file. Users who contacted MPR also complained that the site buries details about co-pays.
MNsure officials said consumers will be able to compare more details about each plan in the future, but haven't said when.
4. "Is it important to keep your current clinic or hospital in your plan's network?" - MNsure website.
If your answer to this question is "yes," you're out of luck — at least for a while.
The MNsure website won't yet let users easily browse to see which health plans cover visits to an individual doctor or clinic. Instead, MNsure directs consumers to insurer websites.
Todd-Malmlov points out the state Department of Commerce didn't approve insurer plans until early September. Technically speaking, it would have been too much to make a more streamlined directory in time for MNsure's launch.
Still, she said it is an important feature. "We're trying to get that up as soon as we can," Todd-Malmlov said. Watch for the directory some time in 2014.
In the meantime, Minnesota Public Radio News has developed a search tool that will let people find out which plans cover visits to individual clinics.
5. "[Navigator] training will take place in August and September in preparation for Oct. 1." - David Van Sant, MNsure Navigator Broker Manager said during a webinar, June 11, 2013
An array of non-profits, medical clinics, hospitals and county workers will help enroll more than one million people in health insurance through the exchange.
But few were ready to go on Oct. 1, and MNsure is still behind in certifying that these assisters have been vetted and trained.
Part of the problem is that MNsure didn't launch training until the week before MNsure opened — the very tail end of the timeframe Van Sant mentioned in the June webinar.
At the time, Todd-Malmlov told MPR News that the delay was the result of fine-tuning the training. "We want to make sure we are providing the most up-to-date information and training," she said.
Slowly but surely, MNsure is adding new assisters to its site.
But there are still delays. Todd-Malmlov said that the certification process is going quickly on MNsure's end. The agency is waiting on groups to finish the training, which is taking some assisters 20 hours to complete — a big lift when they have other responsibilities.
Meanwhile, insurance agents and brokers, who were among the first to be ready to help consumers still don't have access to a web service they say is necessary to enroll people in health plans.
MNsure officials acknowledge the problem and are telling agents they can still enroll clients who come in to the office and help them navigate the MNsure website over the phone.