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Calling her staff "troopers," Beth Schmidt used toy paratroopers to encourage her staff to jump in and hang on with the challenging task of helping people sign up for health care.

As MNsure was preparing to launch two years ago, Beth Schmidt expected there would be some challenges.

A senior eligibility worker for Olmsted County's Family Support and Assistance, Schmidt passed out sheets of paper reminding colleagues of when President John F. Kennedy announced he wanted to put a man on the moon within 10 years.

Co-workers decorated their cubicles with toy parachute men to psych themselves up for using the new system. But nothing prepared Schmidt for just how difficult and maddening the technology system proved to be. And while the MNsure site has steadily improved during the past couple of years, Schmidt said it remains inefficient and frustrating.

"I have apologized more in the last two years to clients than I have in the previous 35 years," she said.

While MNsure provides an online place for consumers to shop and compare private health insurance plans, it also is used by eligibility workers to enroll low-income Minnesotans in the state's public health care programs — Medical Assistance and MinnesotaCare. Of the more than 616,000 enrolled in health insurance on MNsure, about 547,000 are enrolled in public programs.

County workers who use the MNsure system on a daily basis say it continues to be difficult and time-consuming to use. It frequently sends out inaccurate notices to clients that staff members have to correct. Representatives from MNsure and the Department of Human Services say work is continuing to improve the website.

Meridee Brown, Olmsted County Family Support and Assistance supervisor, said changes to enrollees' information that used to take a matter of minutes can take up to 10 times as long — provided no errors are made while filling out the forms. For instance, changing an enrollee's address involves working through 18 pages of detailed instructions. If one error is made, the worker has to start all over again.

"If we were in the private sector when this was launched, there would have been a three-month assessment, and they would have said, 'This is no good,'" Brown said.

MNsure Interim CEO Allison O'Toole said work is underway to correct these problems and improve the technology.

"This is a massive IT project. I think the timeline was underestimated from the beginning. This isn't a secret and the rollout was tough," O'Toole said.

In the early months, she said the focus was on improving the shopping experience for consumers looking for private plans. Over the last nine to 12 months, attention has shifted to improving how the system works for public program enrollment. She added that a special effort has been made to make sure counties have a voice. A county representative serves on the MNsure Executive Steering Committee, which prioritizes what upgrades need to be made to the site.

Still, Olmsted County workers say they remain frustrated by how long it's taking to make the site functional. Brown said unlike an online banking site, there is absolutely nothing intuitive about the MNsure site. Using it requires painstaking attention to detail out of fear that a mistake will be made and work will have to start all over again. Adding to the complication is that the instructions themselves can change — often without notice.

"These guys have to spin in a circle three times and throw the potato over their left shoulder," Brown said, "and two days later, it's like sorry, we didn't mean left shoulder, we meant right shoulder."

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