The Optum Indictment

MNsure has been a disaster for months but, if this article is right, its worst days are still ahead. First, a little background is required. Optum, a software company, was hired by the MNsure Board of Directors to conduct a study on the state of the MNsure exchange. It’s within that context that they made this statement:

“In its current state, the existing MNsure system will not support enrollment expectations,” the Optum report stated.

That’s just the tip of the iceberg:

Starting next year, MNsure must fund its operations by withholding up to 3.5 percent of the value of premiums for commercial policies sold on the exchange. The current pace of enrollment is falling below targets, which means the health exchange could face a budget deficit starting next year.

That’s adding insult to injury. The MNsure policies are expensive, with most people getting forced into policies with expensive deductibles and higher premiums. Next, they’re getting into policies that include coverages that they don’t need or want but that a government ‘expert’ says is required. Finally, some families get disjointed coverage rather than being able to buy a single policy for the entire family.

Unfortunately, the MNsure disaster doesn’t end there:

The report recommended a new program management structure for MNsure because the current structure and process is “nonexistent.” It added: “Management/leadership/decision making is occurring via crisis mode.”

Optum’s report supports Jim Nobles’ observation:

Nobles also said he would look into the effects of the May contract amendments. “It’s certainly something that I will pursue very vigorously to find out what triggered that decision,” Nobles said when the amendment was brought to his attention. “What exactly did it mean? Who exactly was…doing the project management?”

This isn’t surprising. Incompetence has been MNsure’s hallmark since it was implemented. Here’s Ed Morrissey’s commentary on the sad state of affairs with MNsure’s call center:

People can call into MNSure to get assistance in sign-ups, but that’s also a problem. Wait times are averaging 50 minutes in the call center, which is another area in which management is non-existent. The independent panel recommends hiring another 100 operators, but that will take time, plenty of training, and one hopes no small amount of background investigation before allowing access to that kind of private identity data. Speaking as someone who ran specialized call centers for 15 years in the context of highly-sensitive data, I can attest that there is no way to get that many operators up to speed in that short of a time frame, even if you could hire them all today.

As predicted, MNSure is crashing and burning as we speak. Insurers here expecting a windfall of healthy, young enrollees are going to rethink next year’s premium schedules — and Minnesotans will get the bill just as we go to the voting booth in the midterms.

Addendum: Even when I briefly ran a health-sector call center in the mid-90s, where wait times weren’t a big focus of customer service, a 50-minute average would probably have gotten me fired.

This afternoon, DFL Party Chairman Ken Martin accused Republicans of not helping fix MNsure. What Martin isn’t admitting is that MNsure isn’t fixable. I don’t doubt that they’ll probably get the website running. That isn’t the only problem with MNsure. The policies are expensive, the deductibles are sky-high and the management team is incompetent.

Other than those things, the other problems MNsure has are relatively minor.

There’s no escaping the fact that MNsure is a disaster because the Anything But Affordable Care Act is a disaster. Here’s another important part of Optum’s report:

Their first two options take different approaches to reworking the website over the next two years. The third and more dramatic suggestion put forth Wednesday would have the state create new software architecture for the MNsure website.

In other words, admit that the thing is a total failure and start from scratch. I’d love hearing Chairman Martin explain how you fix a total disaster. If Chairman Martin thinks MNsure isn’t a total disaster, he should watch Pat Kessler’s report on its failures:


Chairman Martin, let’s hear your explanation for fixing MNsure after watching that. Optum itself says it might be better to just scrap the existing system and start from scratch.