Monday was the deadline for the uninsured to obtain health coverage for this year — and to avoid a tax penalty.
With that in mind, officials with MNsure, the agency that runs Minnesota's online insurance marketplace, expected to be swamped.
Procrastinators didn't disappoint them, as MNsure's call center fielded a record 25,000 calls. The website also was slowed by high volume.
But it did not buckle as it did Dec. 31, the last big deadline for enrolling in coverage. On that day, frustrated Minnesotans who needed coverage to start Jan. 1, overwhelmed the call center, which forced callers to wait for an hour on hold.
But Monday's rush showed that the MNsure website has improved. MNsure followed an independent consultant's advice and added 100 representatives to its call center, which appeared to handle the overload. The state also beefed up MNsure's website, interim CEO Scott Leitz said.
"We've added additional capacity for the surge to the site to ensure that people are able to get in and that the system itself can handle additional volume," Leitz said. "Beyond that, we're monitoring by the minute the stability of the site and where things are at."
Consumers said the site worked far better on Monday than it did last fall. Those particularly with relatively straight-forward cases appeared to be going through fairly smoothly.
MNsure leaders will announce Tuesday how many people enrolled during the last-minute surge. The late applicants could help the agency achieve enrollment numbers that far exceed its revised goal of 135,000 that was set last fall. Other states, whose websites are not yet functional, likely will fall far short of their enrollment projections.
MNsure serves people who need commercial plans and those who qualify for public health insurance programs. The website is not without problems.
Counties have a separate access point to MNsure called a worker portal, which they use to review applications to government programs such as Medical Assistance.
Linda Bixby, economic support division manager for Washington County Community Services, said county workers still can't make the most basic changes to a person's case. For example, they cannot change an address or close a case for someone who has found a job that provides health insurance.
"I personally have serious concerns about the functionality," Bixby said. "It appears that a significant amount of work would need to be done for MNsure to be a real viable solution for counties to manage and maintain the cases that we need to for individuals and families receiving medical assistance."
MNsure officials say there are still hundreds of people stuck in insurance limbo, whose cases are deemed "pending."
One of them is Susan Leem of St. Paul, a married mother of two, whose current insurance expires on Tuesday. On March 6, when she first applied, the MNsure site said her husband qualified for MinnesotaCare. The site said she and the children qualified for Medical Assistance, but Leem doubts that because of her income. She needs coverage to begin Tuesday, but her case is still pending.
"For me it's the not knowing," she said.
Human Services Commissioner Lucinda Jesson said people in that kind of limbo should make sure they complete the Enrollment Attempt Form on MNsure's website or call the contact center before midnight. That would document that they have attempted to enroll before the deadline, allowing them to complete enrollment after Tuesday — with no penalty for being uninsured after the deadline. Jesson said they would still have insurance coverage as of Tuesday.
"So if they end up having to go to the doctor or the emergency room, we can work with them to make sure that if they're eligible for one of our public programs, that they're getting the coverage they need and it will be retroactive," Jesson said.
But the possibility of retroactive coverage doesn't give Leem peace of mind. As she cradles her infant son in her lap, she still worries.
"If I get into a car accident and I need emergency surgery and they ask my husband where is your medical card, can he say, pending 'MNcare?'" she asked. "Maybe they'd reimburse me later; maybe they wouldn't if my paperwork was not deemed eligible or correct."
The site will go offline for about 48 hours starting at midnight to perform site maintenance and is scheduled to come back up on Thursday morning. People will still be able to visit MNsure.org for general information but the site will be down for things such as: creating accounts; shopping; signing-in and paying. The contact center will remain open, however.