In response to continued challenges in implementing new health care insurance requirements, Olmsted County Community Services' Family Support & Assistance Division has prepared the following update in an effort to keep residents informed about the latest developments and to provide contact information to request assistance, where available.
What is MNsure?
MNsure is the new state exchange for health insurance, created by the State of Minnesota as part of the implementation of the Affordable Care Act (ACA) of 2010. The exchange allows people to enroll in private market plans as well as public health care programs. As of mid-December, approximately 65,000 Minnesotans have used MNsure to apply for private market plans, and approximately 33,000 have used MNsure to apply for public health care programs.
Publicly funded health care programs
In the United States, there are 3 major publicly funded health care programs: Medicare, Advanced Premium Tax Credits, and Medicaid. Medicare is a program created for people over the age of 65. In 2012, there were approximately 820,000 Minnesotans enrolled in Medicare. Medicare is unaffected by MNsure and uses completely separate enrollment processes. Newly available federal tax credits-called "Advanced Premium Tax Credits"-- are a second form of public health care assistance. These credits are only available through MNsure for people under a certain income threshold. (When people qualify for a tax credit, it is like receiving a coupon for a discount on their health insurance premium when they use MNsure to enroll and pay.) The third major publically funded health care program in the United States is Medicaid, which provides medical assistance to people with low income.
Role of counties in MNsure
The role of counties in MNsure is primarily around Medicaid. Federal Medicaid funding flows to the states and is handled slightly differently in each state. In Minnesota, Medicaid is used to fund a program called 'Medical Assistance' (MA), which provides health insurance for low income Minnesotans. In November 2013, approximately 725,000 Minnesotans were actively enrolled in MA. This number includes about 17,500 people in Olmsted County.
In Minnesota, people access the MA system through the county systems. Until now, the counties have relied on a relatively old computer system to process MA. Since the opening of MNsure on October 1, people have been applying for health care insurance through MNsure. Some of these applicants are eligible for Medical Assistance.
Problems with MNsure
As widely described in the press, there have been many issues with the MNsure website. Initially, some of the issues were caused by a federal data hub that is meant to automatically confirm IRS data. Since that time, there has been a rash of other major technological issues with the site. Consumers trying to use the site to submit applications have had a difficult time with glitches in the website.
County workers and others are also having a hard time with the MNsure technology. In order to process applications, answer questions, and assist people with applications, county workers need the technology to work as intended. Unfortunately, there are several major problems that currently hinder the county's work, including:
Limited number of workers have access to system.
Training for systems is not available-therefore workers have not been trained on all parts of the system or changed policies.
Many applications (about 4500 statewide) have been caught in a variety of 'processing errors', which means that the county must wait for state to fix the cases.
The system does not allow workers to view more than 100 tasks that require attention at a time. This means that workers do not know what cases or work exists beyond the 100 that are visible.
Most of the tasks on the initial queue of 100 cannot be removed either because the technology cannot manage the item or the training to complete the task accurately has not been released.
About 2,100 paper applications have been sent to the state, but there is not a good or easy method of entering the paper applications into the electronic system.
What comes next?
MNsure and the State of Minnesota are working hard to fix the many issues that exist with MNsure. The first priority is to fix system defects that are preventing enrollment of people buying private plans by the deadline of January 1. Last week, MNsure announced that the deadline for people needing private plan insurance coverage by January 1 would be extended to December 31.
Although it is MNsure's highest priority to process applications for January 1 enrollment on time, the timeline for resolution of all issues (e.g., applications that have processing errors, paper applications that have not been processed) is uncertain. Further instructions for these situations will be coming from MNsure or the State of Minnesota.
Unlike private plans, there is no deadline and no open enrollment period for Medical Assistance; it is always open and available for application. However, there is no timeline for fixing the system to allow county workers to be able to process the existing Medical Assistance application, answer questions, and help people with applications. Similarly, there is no deadline for training applications to be released to county workers.
If you are an existing Medical Assistance client....
If you are already enrolled in Medical Assistance, you do not need to do anything different at this time. Most existing cases will be moved from the old computer system (MAXIS) to the new computer system (MNsure) at the point of your case renewal, starting in April of 2014. You will receive instructions in the mail from the State of Minnesota and Olmsted County at the time of your annual renewal. If you have questions about your case and you live in Olmsted County, you should call Olmsted County Family Support and Assistance at 507-328-6500.
If you are an existing MinnesotaCare client....
Many people with MinnesotaCare coverage will be transferred into Medical Assistance. This is because the income limits for eligibility in Medical Assistance increased as part of the Affordable Care Act (ACA). If you are a current MinnesotaCare client, you do not need to do anything different at this time. The State of Minnesota will send you instructions in the mail at the time of your next renewal. If you have questions about your case, you should call Minnesota Health Care Programs Member Help Desk at 651-431-2670 or 1-800-657-3739.
If you applied for Medical Assistance coverage through MNsure and you are experiencing difficulties...
Your case will be processed by the County as soon as possible. If you are eligible for MA, coverage can be retroactive up to three months, depending on the circumstances. If you live in Olmsted County and you have questions about your MA application through MNsure, call Olmsted County Family Support and Assistance at 507-328-6500.
If you applied for a private health plan through MNsure and you are experiencing difficulties...
Your case will be processed by MNsure and the State of Minnesota as soon as possible. You should contact the MNsure Toll-free Contact Center line with any questions: 1-855-366-7873 (1-855-3MNSURE).