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Is MNsure in Need of a Radical Restart?

While the latest glitch has been fixed, the backlog it caused remains -- and the state is still uncertain of what course to take.

(TNS) — With yet another embarrassing glitch for the technology behind Minnesota's embattled MNsure agency, policymakers are debating whether the best way forward is incremental improvements or a more radical restart.

The latest goof: a technical glitch in May that delayed the renewals of about 64,000 families on MinnesotaCare or Medical Assistance, Minnesota's public health care programs.

Those programs are run by the Department of Human Services, but since 2013 they use MNsure's software to process and manage cases. MNsure is best known as a website where people can purchase subsidized private health plans, but behind the scenes its software manages hundreds of thousands of Minnesotans' health care through public programs.

The May glitch has been fixed, but the backlog it caused remains. Another roughly 116,000 families have their own renewals backed up as government workers fell behind.

Faced with either depriving hundreds of thousands of people of health care or possibly paying to care for some ineligible families, the state opted for the latter. Typically about 5 to 10 percent of public health care program enrollees up for renewal end up being ineligible, said Department of Human Services deputy commissioner Chuck Johnson.

Of those 180,000 families, about 120,000 are now in the process of being renewed. Another 60,000 have been told they need to provide information or have their health care cut off.

Meanwhile, the software still has huge problems with one of its core functions: updating a case file to account for basic life changes, such as a marriage or the birth of a child. That's not expected to be fixed until 2016.

"We're as frustrated as anyone else," said Johnson. "What we're doing is making our best effort to manage those problems as best we can."

Johnson said going forward is the best option. The old software dates to the 1990s and has limitations of its own. Starting from scratch could be both expensive and time-consuming.

"As far as dumping the whole thing and starting over, part of the issue is, that's about an 18-month process," Johnson said. "That's 18 months of making no improvements to this system. We think we'll be in a better place in 18 months (by improving the current system)."

Republican lawmakers take a different approach.

"If something didn't work, you've got to let it go and you've got to start over," said state Rep. Greg Davids, R-Preston and the co-chair of a legislative committee overseeing MNsure.

But the alternative proposed by Republicans on Monday wouldn't directly impact the 180,000-case backlog on public programs. They want to essentially abolish MNsure as a state agency and hand the state's health insurance marketplace over to the federal government to run.

That would affect the 65,000 people who bought private health plans through MNsure. But the hundreds of thousands of public plan enrollees would still need software to manage their cases whether MNsure was turned over to the federal government or not.

State Rep. Matt Dean, R-Dellwood, said it would still be a good move to change course. "If MNsure was a private company, the state of Minnesota would not allow them to continue to do business with the practices they have."

What course to change to, remains uncertain. Dean said lawmakers should talk to county employees who do much of the work managing cases and ask them "what works the best."

"We've invested a lot in the infrastructure," Dean said. "We don't really know how much of that is salvageable."

Minnesota will spend $229.6 million on MNsure technology through June 2017. Almost all of that is federal money, with the state's share at $16.5 million.

State Sen. Tony Lourey, DFL-Kerrick, said he's willing to talk about moving MNsure to a federal exchange, but is "not ready to call for a wholesale scrapping."

MNsure "is not a system," Lourey said. "There's 10 systems, some of them working better than others. We do need to take a look at those that aren't working. We need to continue to improve all of them, truthfully, and maybe scrap some of them. That's OK."

©2015 the Pioneer Press (St. Paul, Minn.), Distributed by Tribune Content Agency, LLC.