ST. PAUL, MINN. — Days after Minnesota's online insurance marketplace had a less-than-trouble-free launch, MNsure officials are betting that consumers will have a smoother experience this week. But the site is not in the clear yet.
Intermittent problems with account creation continue for users of the online health insurance marketplace, and weekend fixes to a key federal component of the system appeared to trigger a new set of problems.
"This is having a little bit of an impact on us," MNsure executive director April Todd-Malmlov. "We are working with the federal government right now to evaluate that. This issue appears to be minor so we do anticipate that we will be able to get this fixed with them quickly.
Todd-Malmlov says the MNsure site will include notice of the problems while they're ongoing. She said consumers who are unable to get through on the site should try again in a couple of hours.
Despite the ongoing troubles, MNsure officials say the website - which is run by the state, not the federal government - performed well compared some in other states, in part because MNsure delayed its start until the afternoon of the first day.
"I think we were the only exchange in the country that didn't have a major crash on the first day," said MNsure chairman Brian Beutner, who is thrilled with the rollout. "That enabled people to come in and see what they could find and then quite frankly be able to completely access the system."
That's not a universally held assessment, particularly among those who had to use the system. Last week, frustration levels ran high as some users reported getting booted off the system while trying to create accounts.
"It would get so far and then freeze -- and then it would log me off," said Mike Corbin, an attorney in Medford, Minn. "You just kept having to redo it and redo it and redo it. And then you'd come to what I call a 'death screen' where there's just a bunch of gibberish... and it would just keep kicking you off the system."
Corbin said he was able to create an account, but got no further. After waiting on hold with the MNsure call center, he gave up and made an appointment with an agent to get help.
That was a common complaint in MNsure's first days as exasperated consumers vented on news and social media sites about difficulties creating the accounts needed to enroll in a health plan.
Consumers have until Dec. 15 to sign up for insurance that will be effective Jan. 1. A three-month grace period early next year will allow consumers to buy insurance by the end of March without incurring a federal tax penalty for lacking coverage.
The flood of criticism on the site's start earned MNsure's mixed reviews from the board's vice chairman, Pete Benner, a former state employee union leader who for decades has advocated affordable health care.
Benner said the good news is that MNsure is up and running, which in his words, is "a big deal." The not-so good news, he said, is the rollout was rockier than he would've liked.
"[It] sounds at this point that most of that is due to connections to the feds, not to the design here in Minnesota," he said. "But to the end user that doesn't matter, right? If the experience was not good, the experience was not good."
Dan Schuyler, who served as an information technology director for Utah's health exchange when it began several years ago, agreed that bad experiences by users can hamper any system's chances of success.
Schuyler said consumers who are desperate for health coverage will keep trying to create accounts. But the people who the exchanges desperately need to participate if they are to succeed financially -- uninsured young people -- may be ambivalent about whether they need coverage. They also may lose interest:
"We're trying to market to a very tough segment of the population," Schuyler said. "They don't have insurance now because they don't feel like they need it for whatever reason. And if you can't provide a seamless, intuitive experience for these individuals, you could quickly lose them."
There is time for the exchanges to gain a foothold, said Joel Ario, former director of the federal Office of Health Insurance Exchanges.
Ario, who now works as a consultant, said the time to start worrying about problems impeding enrollment is in November.
"Here in October, most people are just going to want to browse, see what their options are, think about it," he said. "Because even if they were tempted to purchase already...I don't know how many people want to pay in early October for coverage that's not going to be effective until January."
MNsure board member Thompson Aderinkomi, an entrepreneur who has started health data businesses from scratch, thinks MNsure is off to a great start.
"This is an extremely fast and large roll-out and most start-ups would only dream of things going this smoothly with such a large number of users trying to get a product or service that means so much to them," he said.
This story is part of a collaboration that includes Minnesota Public Radio, NPR and Kaiser Health News.