Editor’s Note: Rep. Tara Mack is a Republican member of the Minnesota House of Representatives, representing District 57A (Apple Valley and Burnsville). She serves as chair of the Health and Human Services Reform Committee and serves on the Health and Human Services Finance, Rules and Legislative Administration, and Ethics Committees. She spoke with Health Care News Managing Editor Kenneth Artz about the future of MNsure, the state’s troubled health insurance exchange created under Obamacare.
Artz: We have heard MNsure got off to a rocky start, especially the exchange’s website. What problems has it experienced, how much has it cost taxpayers, and if it remains in place, what can they expect from it in the future?
Mack: MNsure’s website has been plagued by constant glitches, malfunctions, and setbacks since its launch in October 2013. Simply put, the website was not ready when it went live, and it still isn’t able to handle basic functions, such as eligibility checks, processing enrollment info, and sending bills to people so they can make their payments.
During the first open-enrollment period, the website was a disaster for anyone attempting to use it, and the call center was understaffed and unable to handle the significant number of Minnesotans calling in who were struggling with the broken website.
In 2014, glitches forced 16,000 low-income Minnesota families to wait as long as six months for coverage, 3,000 Minnesotans received incorrect bills from the Department of Human Services, and 8,700 Minnesotans were incorrectly told to renew [their] coverage by August 1, 2014, or else their coverage would be canceled. These were just some of the examples of the problems reported over the past year.
In July of this year, we learned there is a 180,000-case public program backlog, putting coverage at risk for more than 60,000 people, with the system still unable to perform basic eligibility checks to keep fraud and waste out of the system. [The Department of Human Services] announced it would no longer use MNsure to send invoices for MinnesotaCare, Minnesota’s program for people with incomes too high to qualify for Medicaid.
All of these problems and more have been caused by a website that has cost taxpayers more than $200 million to build. If it remains in place, we can expect to see continued headaches, with Minnesotans ultimately paying the price for programs that aren’t working as promised. It’s going to cost us tens, if not hundreds, of millions of extra dollars simply to get the website up to where it was supposed to be two years ago, in addition to the ongoing costs [associated with maintaining] the exchange into the future.
This is a bad deal for taxpayers, and a bad deal for the Minnesotans who are dealing with the consequences of these broken promises.
Artz: Gov. Mark Dayton, a Democrat, says officials need to give MNsure more time to prove it’s viable. Do you think it’s still possible for the exchange to prove its worth, or is it just expensive, clunky, and redundant?
Mack: October will mark two full years since its launch, and four years since development began after Gov. Dayton accepted money to begin its construction, and MNsure is still nowhere near where it should be. That’s why Republicans have been advocating looking at the options available to us now that the King v. Burwell case has been decided. If it’s cheaper and less of a hassle to go onto the federal exchange, we absolutely should take a look going down that road.
Minnesota has been an innovator and leader in the health care realm for decades. We see this as an opportunity to continue that leadership and use the options available to us to solve the problems MNsure has created.
It’s a conversation that needs to happen so we don’t continue throwing good money after bad.
Artz: The Supreme Court’s ruling in King upholds nationwide tax subsidies for health insurance. Is this the opening Minnesota needs to shut the doors on MNsure?
Mack: King v. Burwell gives us a number of options the governor, MNsure leaders, and legislators here at the capitol should consider. There are waivers and partnership models available to states that wish to set up hybrid systems that rely wholly or in part on the federal exchange to accomplish the same goals.
A hybrid model would allow us to focus on basic functions like prompt consumer service and management of insurance plans sold in our state without worrying about trying to fix a duplicative IT infrastructure.
It’s our hope Democrats and state officials will join us in looking at all the options and making an objective decision about whether it’s the right time to move away from MNsure and transition to the federal exchange.
Artz: A proposal to abolish MNsure and move to the federal marketplace by 2017 stalled in this year’s legislative session. What happened? Will your state get another chance?
Mack: Unfortunately, our Democrat colleagues in the Senate were uninterested in considering any changes to MNsure until the King v. Burwell decision was announced. As a result, the Senate took no action regarding MNsure, leaving it wholly intact during the 2015 session.
Now that we’ve moved past the King v. Burwell case, it’s our hope that we will seriously look at all the options in front of us and have an honest conversation about the best course moving forward.
Kenneth Artz ([email protected]) is managing editor of Health Care News.