Despite all of the problems plaguing Minnesota's online health insurance last year, under the Affordable Care Act the state's uninsured rate dropped by more than 40 percent, according to University of Minnesota research.
By late spring, 95 percent of Minnesotans had insurance.
With its technical and managerial problems out of the way, MNsure officials are focusing on a big challenge: convincing Minnesotans who are still uninsured to obtain coverage.
MNsure is trying to re-enroll people who signed up initially and convince the remaining 5 percent of Minnesotans to comply with federal health insurance mandate.
"The low-hanging fruit is gone," said Joe Campbell, MNsure's director of marketing and communications.
"So our campaign and our whole marketing strategy is really focused at getting people that are in the shadows of the uninsured and bringing them out and make sure that they know what options are available to them," he said.
MNsure research found that people who have refused to enroll in a health plan generally fall into one of two categories: those who believe they don't need insurance and those who don't think they can afford it.
To convince both groups that having health insurance is to their advantage, the agency is using market research and targeted advertising.
One TV ad, which is part of MNsure's multimillion dollar effort to bring Minnesotans to its exchange, is aimed at millennials, those born from the early 1980s to the early 2000s. MNsure officials call them "invincibles," because many don't think they need insurance.
The light-hearted spot features a 20-something working on his bike. After he mentions how easy it was to sign up and how affordable his plan turned out to be, he jams his finger on a spoke.
"Now you're covered," a friend says.
"Yep, I mean if I ever need it," he replies. "Ah!"
"You probably need it."
The other ads are much more serious. One features a woman wrapped in a towel trying to figure out what to do about mark on her upper chest.
"Should I get it checked? I don't know. I can't afford a doctor visit without insurance. I'll just keep an eye on it."
Another shows parents worrying about a feverish child.
"We need to take him to the doctor," the mom says.
"I think we should wait," says her husband. "I mean, without insurance it'll cost us."
According to MNsure research, uninsured Minnesotans who want health insurance typically are parents, women of every ethnicity and Somali immigrants familiar with universal health care in their homeland.
Those less interested in getting coverage tend to be people who think they're healthy. They are most often millennials, people without children, and men. A disproportionate number of them are Latino.
Rebecca Lozano, outreach director for Portico Healthnet in St. Paul, which connects people to health care, likes the new ads. She thinks they're an improvement over MNsure's initial Paul Bunyan campaign.
Still, Lozano said, the ads seem to be targeted at middle class people, not low-income people of color who are most in need of coverage.
"I think they've got a good start in trying to find a lot of folks that, you know, maybe missed out on the tax credit or the qualified health plan enrollment," Lozano said. "But [they] may or may not be getting at the folks that we really see most, which are really those at-risk populations."
MNsure officials say the ads are part of a broad strategy to convince more people to get coverage and that's why it also funds outreach efforts by other groups — including Portico Healthnet.
Campbell, the MNsure spokesman, said most of the ads are hard-hitting because convincing the holdouts is a hard sell.
"We know that it's very difficult to change people's behavior. We know that it's even harder to change people's behavior when they have to pay for it," he said. "And so getting people into a place where they're thinking really consciously about the situation they or their family or their friends are in was a deliberate attempt by us to make the lives of people without health insurance very real."