Update on MNsure

I think this is fascinating -- a media update on where MNsure stands, heading into the final days for open enrollment:

Editorial board members,

I am writing to bring you up to speed on the happenings at MNsure in the last few days before the end of open enrollment.

There are just four days remainingfor families and individuals to enroll in quality, affordable health coverage through MNsure. If your readers don’t attempt to enroll in a plan before Monday, March 31, they could be putting their health and financial future at risk and may also be required to pay a penalty of $95 or up to 1% of their total household income (whichever is greater).  (The open enrollment deadline does not apply to those seeking Medical Assistance or MinnesotaCare, small business owners or members of Indian tribes).

As an organization, we want to make sure every Minnesotan that wants health insurance coverage gets it. I am writing today to ask that you help us spread the word to people across the state.

Attached to this email is a flyer that includes some statistics about the consumer experience (e.g. call center staffing, website functionality, etc.) that you may find helpful.  Also, I thought the FAQs below might help you as you continue to cover MNsure. 

I recognize that time is short, and deadlines for print versions of your paper may have long since passed.  Anything you can do to spread our deadline message is always appreciated.  As always, please call me if you have any questions.

What are your current enrollment numbers?

As of March 26, 2014

·         148,068 Total Enrollments

o   75,676 Medical Assistance (Medicaid)

o   41,273 Qualified Health Plans (QHP), plans sold by private insurance companies on the exchange

o   28,540 MinnesotaCare

On Tuesday, you reported total enrollment of 136,000, today it’s more than 148,000. Why the big jump?

We had been processing a large batch of manual enrollments and we’re now in a position to add them into the mix.  They accounted for a 14% increase in QHPs – 4,189.

While you have exceeded your goal for total enrollments, it is the commissions you get from selling QHPs for the private plans on the exchange that generate your revenue.  Last October you projected that you would sell 70,000 QHPs, today you are projecting 50,000.  Why the change?

As is the case with any new organization or agency, in the beginning months, you base much of your work on projections, not experience.  Projections were made many months before we had any experience in the marketplace enrolling people in health insurance.  That, coupled with technical glitches during the first few months of the roll out, has contributed to lower-than-expected enrollment numbers.  Now, our site is stable and we are enrolling up to 2,000 people a day.  We’ve adjusted our budget to reflect that reality, cutting our expenses to match our revenues. 

Does this mean you will have a budget shortfall?

No. We have adjusted our spending so it is in line with our revenues. Our budget is balanced through 2015 and we won’t need to ask for additional funding from either the state or federal governments to operate the exchange.

Do you expect to hit your goal of 50,000 QHPs?  What happens if you fall short?

The 50,000 QHP goal is for calendar year 2014.  Because we are only 9,000 enrollments away from that number, we do expect to reach that goal. If we do not hit the goal and fall a bit short, we will adjust our budget again to match our revenues.  A balanced approach to budgeting is a priority for the organization.

Why has MNsure revised its enrollment projections numerous times?

This is the first year Minnesota has operated a health insurance exchange, so we did not have past experience on which to base our projections. Shortly after the enrollment period started in October, we were able to compare the projections that had been made prior to launch against the realities of operating the exchange in a real marketplace.  At that time we set our goal of 135,000 total enrollments.  On March 23, 2014 we exceeded that goal. 

While the total goal has been met, the makeup of the types of enrollments that brought us to that number is very different than our projections from the middle of October. We anticipated that 70,000 of the 135,000 total enrollments would be consumers signing up for private insurance plans. It now looks like that number will be closer to 50,000.

MNsure proposed a budget to the legislature that required rolling over $5M in federal money.  Does that mean MNsure is operating in deficit?

No. Shifting $5 million in unused federal funds from FY 2014 to FY 2015 will allow MNsure to operate with a balanced budget. There will be no need to seek additional state or federal operating funds.

In your most recent budget, are you spending an additional $12.5 on your technology system?

All budgets are about setting priorities. MNsure’s board has determined that enhancing the consumer experience on the online exchange is a top priority. Adjustments in other areas were based on actual utilization and will free up resources to improve the online marketplace. This reallocation of resources is part of the balanced preliminary budget our board approved for submission to the legislature.  This budget reallocation does not affect the bottom line.

How do you respond to individuals who continue to characterize your website as "barely functional?"

The website had significant issues in the fall of 2013, but our staff and vendors have worked hard to stabilize the online marketplace. Currently, up to 2,000 people are enrolling in plans on the MNsure exchange every day with almost 400,000 visits to our website last week alone.

What assurance can you give to people who attempted to enroll in December and faced call center wait times of over an hour that this time will be different?

With the help of an outside vendor we have more than doubled the staff in our call center. Call wait times have dropped from a peak of over an hour to much lower averages as we began the final week before enrollment. However, we do anticipate call wait times to increase as we approach the final deadline for enrollment at midnight on Monday. Those seeking assistance are urged to utilize extended weekend call center hours.