MNsure is open for business.
The state's new health insurance marketplace has been years in the making, and more than one million Minnesotans are expected to use the site to find coverage by 2016.
"We are very happy and pleased to be open this afternoon," said MNsure Executive Director April Todd-Malmlov early Tuesday evening.
But the massive, $100 million information technology project wasn't without glitches Tuesday afternoon.
Most notably, the website wasn't always able to verify the identity of potential consumers. The hiccup initially prevented some users from creating accounts on MNsure. The accounts are necessary for applicants to find out if they are eligible for federal subsidies or government programs, and to buy a commercial health plan through MNsure.
Todd-Malmlov said officials traced the problem to a faulty server, and that her staff was working to fix it. And despite the glitch, at least 500 people were able to create an account Tuesday, she added. Todd-Malmlov said that they didn't have information about how many people had paid for a plan.
The MNsure website got 100,000 hits Tuesday - the second highest of any state website - though it wasn't clear to what extent the hits represented people who were shopping for insurance or who were just curious.
Some users reported being booted off the system and having to re-start the enrollment process repeatedly, while others said they had no problem browsing and comparing various plans.
Some features will be added at a later date. For instance, people won't be able to search for plans that cover visits to their current doctor or clinic for the time being. MPR News has a directory here.
MNsure officials also say small business employees will have to wait until later this year to enroll in their employer's plans through MNsure.
Despite MNsure's glitches, it appeared that the system was in better shape than some other state exchanges by the end of the day on Tuesday. Washington state's exchange told users to fill out a form and then expect a phone call, according to Kaiser Health News. Meanwhile, Maryland's marketplace crashed Todd-Malmlov said that wasn't a problem MNsure experienced.
LOOKING FOR A BETTER DEAL
For much of the day, uninsured Minnesotans, Minnesotans with insurance just looking for a better deal, as well as the curious, waited for the site to open.
Mitch Grussing, a 27-year-old piano teacher in St. Paul, is one of them. He currently has health coverage through the Minnesota Comprehensive Health Association, a safety net program for high-risk patients who are unable to obtain coverage otherwise. But Grussing said his condition is relatively easy to handle and doesn't require a lot of treatment. He hopes that the plans on MNsure will offer better and less expensive coverage.
"There are no really good options on MCHA unless you have a really expensive to treat chronic condition," he said. "But if you're like me and you have a — yes — preexisting condition that doesn't necessarily cost hundreds of thousands of dollars to treat, it's going to be great to have a plan that doesn't cost me thousands of dollars a year for coverage that I don't even use."
Grussing said he found MNsure difficult to use in certain Internet browsers, and that the savings he saw weren't as dramatic as he'd hoped. But he said he was impressed with the number of options on the site that he could afford.
"I'm still very optimistic about MNsure and am confident that I can find something that meets my needs either tonight or by sometime tomorrow," Grussing said in an email Tuesday evening.
At Hennepin County Medical Center, where many low income patients go for treatment, MNsure project manager Tony Yanni said his staff has been answering a lot of questions about MNsure today. Many patients are confused about it, he said.
"A lot of people either see the Paul Bunyan ad, or they hear the talk in the community, or they see some of our advertisements around the hospital," Yanni said. "A lot of people think that MNsure is the program itself. So when we explain to them, 'no, MNsure is actually a health care exchange [that offers commercial and government insurance] that seems to really resonate with folks.'"
In other locations around the state, there seemed to be less interest in MNsure.
"The first day, up to now, which is almost noon, is very, very quiet," said Nobles County Administrator Tom Johnson. "To my knowledge we haven't gotten a call yet today."
Johnson believes there are people in his area without health insurance who could benefit from MNsure. He expects that as awareness of MNsure ramps up, more people will want information about the new insurance exchange. He says when they do his county public health workers will be ready.
"They have been working on this program for quite a while, trying to get a good understanding of how they can help people," said Johnson.
Regional hospital systems have been gearing up for the start of the new medical insurance effort. Sanford Health has 15 hospitals and more than three dozen clinics in Minnesota. The South Dakota based company has employees ready to talk with customers about MNsure and how it might benefit them. Sanford's Ruth Krystopolski says the company has also provided training for about 350 insurance agents from the region. She says although there were plenty of technical glitches on the first day, actual deadlines are quite a ways off.
"People have until Dec. 15 to enroll, to be eligible for Jan. 1, and can enroll as late as March 31. So there's plenty of time for people to get enrolled if they're not able to get on today," Krystopolski said.
ASSISTERS STILL WAITING FOR CONTRACTS, TROUBLESHOOTING
The Minnesota system isn't without problems. MNsure officials say none of the network of groups chosen to help consumers will be certified to provide help until Wednesday at the earliest.
Alycia Riedl, president of the MN Association of Health Underwriters, said members of her group have serious concerns about being able to help people use MNsure in the way they're used to - over the phone. Many brokers who have completed the MNsure training have yet to receive certification from MNsure to help consumers. Even when they are, it will be difficult for brokers to help clients unless they do it in person, Riedl said. That's because a quirk in the MNsure system won't allow a broker to set up an account for a client over the phone.
"The MNsure website for individual consumers does not have functionality for an assister to help someone set up an account, guide them through the system, seeing what they see, helping them when they need it," Riedl said.
"The only way that an assister will be able to provide guidance is if they are figuratively or literally looking over the shoulder of the prospective enrollee. Agents want to help their customers as they try to make the very best health care coverage decision they can, and, without all of the necessary tools, agents are concerned that it will prove to be difficult at best."
In Bemidji, Community Resource Connections Director Ruth Sherman said she's still waiting for her contract from MNsure to help educate and enroll people in exchange. Two of her three employees have finished training at this point, but Sherman said she's not waiting to schedule outreach events.
"[MNsure] is a big deal," she said.
Sherman said she has already received calls from local colleges to come and talk to students about MNsure.
MNsure is still working to certify groups and people who have special training to help with enrollment, Todd-Malmlov said. There should be an initial list of assisters on its website by Wednesday, but that will only be a sliver of the brokers, counties, agencies and non-profits who will be involved.
MPR reporter Mark Steil contributed to this story.