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MNsure: Record enrollment for insurance through exchange went smoothly

ST. PAUL — Minnesota's individual health insurance marketplace, MNsure, saw record enrollments and the smoothest annual sign-up period since the agency's troubled launch in 2013.

MNsure announced Wednesday, Jan. 17, that more than 116,000 people purchased insurance through the state market created under the Affordable Care Act, commonly called Obamacare. That's slightly higher than last year, when 114,810 people bought plans, but it falls short of the 5 percent growth agency officials anticipated.

"This was the best open-enrollment period we've ever had," Allison O'Toole, MNsure CEO, said in an interview ahead of releasing the enrollment tally. "We are getting better and more and more Minnesotans are realizing our value to them."

But MNsure and the individual insurance market continue to face uncertainty here and nationally. The Republican-controlled Congress wants to dismantle Obamacare and while Minnesota's market appears to have stabilized, fewer people are buying individual insurance plans.

What the numbers say

The numbers MNsure reported Wednesday cover the annual open-enrollment period that ran from Nov. 1 to Jan. 14. They will not be final until March when insurers report how many consumers who enrolled in coverage paid their premiums. According to MNsure:

• The majority of the 116,358 who signed up during open enrollment were existing customers who were automatically re-enrolled in plans. About 30 percent of enrollments are new customers.

• MNsure receives some of its funding from a 3.5 percent fee on the plans consumers buy. Missing the 5 percent growth target is not expected to impact the agency's budget.

• The sign-up figures also do not include enrollments from the Small Health Options Program, or SHOP, for small businesses that has shifted away from the MNsure exchange.

• Roughly 60 percent of the enrollees qualified for tax credits to help them afford coverage. The average credit this year was $7,000 for households.

While MNsure has seen enrollments grow, the Minnesota Department of Health reported this past week that the overall individual market has been cut in half since 2015, likely because of increased premiums. That means most of the 166,000 people who buy their insurance that way are using MNsure, which is the only way to qualify for tax credits.

Smooth sailing?

MNsure was able to avoid the technical glitches and services hiccups that plagued the agency in the past. Its website logged nearly 1.9 million visits during the 10-week open-enrollment period and the call center fielded almost 150,000 calls.

That nearly 30 percent reduction in calls from the year before was the result of better service and fewer callbacks rather than a decline of interest, MNsure officials said. Call wait times averaged 10 seconds.

"We have made significant progress every year and this year is no different," O'Toole said. "We have worked night and day to make this better."

More improvements are on the horizon. The agency plans to spend $13.1 million over the next five years to upgrade its website and record-keeping system.

MNsure recently picked California-based GetInsured to handle the upgrade, which includes a new plan-comparison tool. The website's existing tool was used 211,205 times during the recent enrollment period.

MNSure officials said the software upgrade will be paid for with existing agency funds and revenues. It will be phased in over the next two years.

Ongoing challenges

Despite continued interest from consumers, MNsure and the individual insurance market continue to face an unclear future.

This season's open-enrollment period was shorter nationwide and the Trump administration cut the Obamacare advertising budget. About 8.8 million people signed up for health plans nationwide, a slight decline from the 9.2 million sign-ups the year before, the Centers for Medicare and Medicaid reported.

Last month, the Republican-led Congress voted to end in 2019 the mandate that nearly everyone have insurance or pay a penalty. There are also ongoing talks in Washington about allowing insurers to offer "associate health plans" to small collaborative groups that would be exempt from some Obamacare requirements.

Debate also continues in Washington over subsidy payments that help most Obamacare enrollees afford their insurance. Last year, the Trump administration said it could not continue those payments without congressional authorization.

In Minnesota, changes to MNsure, and its $45 million-a-year budget, may again be a topic of debate at the state Legislature. Lawmakers have already teamed up to stabilize the individual market with $300 million in premium rebates and $542 million for a reinsurance program to help insurers afford high-cost patients.

Minnesota Republicans have repeatedly proposed ways to eliminate the agency or rein in its reach, while Democrats have pushed to expand the public's ability to buy into government insurance plans like MinnesotaCare.

Despite the uncertainty, O'Toole says MNsure's services are increasingly valued by consumers.

"If you think about what we faced this year," O'Toole said. "A shorter open-enrollment period, strong headwinds from Washington, D.C., news about the repeal effort, and we still beat what we did last year."