MNsure tech issue creates renewal backlog of 180,000 cases

The state is continuing to struggle with public health insurance renewals through the MNsure system, and officials say the problem has now grown into a backlog that includes 180,000 cases.

When renewal issues were first disclosed in May, state officials said that about 55,000 renewal cases in the Medicaid and MinnesotaCare programs were held up due to technical problems.

The backlog has contributed to problems with collecting MinnesotaCare premiums, and making sure coverage is provided only to those who qualify for the health insurance programs. State human services officials said this week that nobody has lost coverage due to delays with renewals, and announced a new plan to fix the problem.

"We're realizing that we're already halfway through the year and we need to move forward pretty aggressively with a plan to get the renewals processed," Chuck Johnson, deputy commissioner with the Department of Human Services, said in an interview.

Republicans who have been critical of MNsure seized on the latest disclosure, saying a legislative oversight committee should be convened.

"We possibly have people in the system who aren't eligible at all," said Sen. Michelle ­Benson, R-Ham Lake. "If you're not eligible, then you shouldn't be getting taxpayer support."

Minnesota launched the MNsure health exchange in 2013 to implement the federal Affordable Care Act. People use the exchange to buy commercial health insurance, and to enroll in public health insurance programs. The state has received $189 million in federal grants to create the system, and is using another $50 million in state and federal Medicaid dollars for improvements.

In May, the Star Tribune reported about the troubles with auto-renewals for about 55,000 people in the public health insurance programs. The problem involved the exchange of income information between the MNsure system and a federal data hub, which checks financial and immigration data to make sure people qualify for government coverage.

The consequence was potentially incorrect determinations about whether people could enroll in public programs.

At the time, it wasn't clear whether the MNsure system or the federal hub was to blame for the trouble with auto-renewals. State officials have since determined that there were problems on both ends, Scott Peterson, the MN.IT chief information officer for the Department of Human Services (DHS), said in an interview.

The federal hub issue has been fixed going forward, but it contributd to the backlog, according to a Thursday ­letter to legislators from Lucinda Jesson, the state's Human Services commissioner, and Tom Baden, the commissioner of the state's MN.IT department.

"The past problems with the data transfers and backlog it created has negatively affected our ability to process life events, issue invoices for MinnesotaCare premiums, and collect those premiums," they wrote. "It has also affected overall program integrity, as people who have failed to respond to information requests cannot be determined eligible."

In an interview this week, state officials couldn't say exactly how many people might be getting coverage when they shouldn't. The risk of people wrongly getting coverage has been highlighted in reports about MNsure by Legislative Auditor James Nobles.

Getting renewals done soon is key, state officials said. In the case of MinnesotaCare, they've set a goal of handling all renewals by Aug. 31.

In about 10,000 cases, the state has gone far enough with the renewal process to send bills to beneficiaries for premiums, which range from $0 to $50 per month. But for another 55,000 MinnesotaCare cases, no bills have been sent for 2015 coverage.

Premiums cover about 4 percent of total costs for the program.

"We have encouraged MinnesotaCare enrollees to continue paying their premiums even when they haven't received bills," the Department of Human Services said in a statement. "We have been receiving about 20,000 checks a month, and collected $6.5 million for the first half of ­calendar 2015."

Of the 180,000 backlog cases, about 60,000 involve MinnesotaCare and Medicaid beneficiaries who have not responded to requests for information to help with the renewal process. The state expected to have an "auto-close" capability to handle such cases, but it's not ready, according to the letter sent to legislators.

"For the 60,000 MinnesotaCare and [Medicaid] cases with enrollees who have not responded to requests for renewal information, we will notify enrollees that their coverage will end unless they respond within 30 days," the letter states.

Another 120,000 cases are in various stages of the renewal process.

To handle renewals in the Medicaid program, the state hopes to get help from counties that are involved with administering the health insurance program. Those county workers have repeatedly voiced frustrations over the past 18 months about problems with MNsure.

Despite the backlog, state officials insist the system is getting better, and they now have a plan for getting ­renewals done.

"We believe we can make the system work," Johnson said.

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck