MNsure Rants

Minnesota is one of 13 states experimenting with a local healthcare exchange under the ACA (most states use the federal HealthCare.gov system). As a Minnesotan it’s been my misfortune to use our state insurance marketplace; MNsure.org.
Rather than writing a full review of the nightmare that is MNsure.org, I’ve collected some of my past frustrated emails to the organization. As there seems to be no centralized tech support or contact point, these have gone to an assortment of agency-related email addresses. I’ve occasionally received responses, typically more apologetic than helpful, but have yet to discover if any of my comments get to anyone who can do anything. This year I also got around to hassling the board of directors and my state legislators. Their contact info is at the bottom of this post, in case you’d like to share your own experience with Mnsure.

2013:

I’ve managed to lock my account on mnsure (after finally getting the site to work long enough to create one), and all of the security verification questions are useless.  The most memorable location in my life? Heck if I know, I can’t remember what I ate for dinner yesterday. My best friend from 3rd grade? I grew up in a ghost town. Where did my parents meet? I’d probably have to call them every time I forget my password. Please change it so users can select actual useful questions of our own, the kind that real people will actually know the answers to. Or you could offer the option to send a password reset email to the registered email address, like every other website does.
This time I’ll be sure to write down the password and all the BSverification questions and put it on a sticky note on my computer at work, where everyone can see it. I don’t even care how secure my password is, based on the quality of programming I’m just assuming the thing will be hacked in the next month or so. (actually I just looked that up and found that mnsure already emailed SSNs to random people last month, nice work).

2014:

I interacted with MNSURE again recently, to change my insurance after PreferredOne gave up on us. I have a few complaints/suggestions for the service. I hate to complain about site usability, since I’m a computer science graduate and have built websites myself… but this site has many obvious things missing:
-The enrollment process needs to be easier to start, with the links easier to find. Currently the page seems to go through two different “Sign in” screens, then one eventually finds their way to the enrollment inside a link past a sidebar menu and under a dropdown. Terrible navigation and terrible user interface.
-The security questions are too limited and not applicable to all persons. If I don’t like sports, am not in a relationship, do not know my grandfather (which one?), have a single parent, have never owned a car, and do not know where I’d like to retire, that eliminates most of the security question options. It would be better to let people enter their own or have more options (or I could just answer “banana” to each one and keep that on the sticky note with my password).
-There needs to be some confirmation code or proof that *something* happened after the enrollment process. I thought that I’d beat the rush on December 15th and get enrolled back in November. I eventually found the sticky note with my password and security questions, jumped through the hoops, clicked all the things that didn’t apply to me, and wasted a half hour on things I didn’t care about. The system told me I had no benefits, discounts, or tax credits coming, so I went ahead and selected the cheapest flavor-of-the-year for insurance providers…. Or so I thought. Now I log in again to find no record of a current enrollment. Instead, it seems I have a pending application for something or other. What did I apply for? What’s the status on this theoretical application? How do I actually enroll in something?
-The site could use better error-handling or retry options. My current session threw an “unable to contact the server” error, then eventually loaded a “Congratulations” page saying my enrollment is completed…. but I got the Congratulations page back in November and never received any follow-up from MNSURE or my chosen provider to indicate that the website had done anything at all. When I click the “done” button it goes to a mysteriously blank page, and the “Enrollments” link still shows no plans enrolled. Am I enrolled or not? It’s a mystery without some kind of confirmation.

-The site could explain itself better. For example, the application page states that I qualify “for help to buy health insurance through the exchange”, then says “$0 off/month” and “0% Reduction”. So, what is this “help” it’s referring to? Not financial help apparently. Does this “help” refer to a MNSURE staff member helping me through the process? If so, that’s not made clear.

-The page layout is also annoying. I have a large (24″) monitor, but the page still requires scrolling and won’t scale to less than 60% of my screen. It would be great if it could all fit in one reasonable space. I understand some people can’t read small text, but you could save a ton of screen real estate by shrinking your header bar, eliminating some of the white space at the top, and de-nesting some of the frames.

Personally, your entire site could be replaced by a big red button that auto-enrolled me in the absolute cheapest thing possible (and spit out a confirmation code). I suspect that would meet the needs of many MNSURE users as well.

And another from 2014:

Once again I made the mistake of using the MNSURE website, and was unsurprised to find it just as useless as every other time.This time I was trying to find a magic “MNsure ID Number” requested by the flavor-of-the-year lowest-cost insurer (who couldn’t even manage to create a real invoice for my first payment). I was hoping to find some kind of account information or settings, but the MNSure site appears 99% geared towards pipelining me into an application, so it took a while. The site still makes me click “sign in” twice in a row, then doesn’t take me anywhere useful once I do get signed in. About 60% of the time I get a blank screen, 30% I get a 403 error, and 10% I get dropped into a new application. I think I’ve completed 3 applications so far with no follow-up to indicate that they went anywhere or did anything.

Anyway, there really needs to be some way of getting to my user account or settings page once I’m logged in. (Yes, I previously stated that the whole site could be replaced with a “Enroll in cheapest thing possible” button, but if the insurance providers are so disorganized that they need me to supply my own account number, then there needs to be a way to extract that number from the site).

On the rare occasions when I can log in AND get to some sort of account information, there seems to be nothing there. No payments, no enrollments, and those three mysterious applications which have mysteriously been “processed” in some way.
I eventually found the magic ID number by accident, hidden in a PDF file under “Notifications”. Then I realized that these “Notifications” also have information about those mysterious applications. They don’t seem to be in any particular order, and are very slow to appear on the screen (if I didn’t click each one and wait around for a few minutes, I’d assume it’s blank like the “Enrollments” page). This is the first time I’ve stumbled across the notices, as I don’t think they’ve been emailed or snail-mailed to me. That’s some useful “notification” right there… I sure do feel informed and notified! Maybe at some point in the past I clicked on “online notifications only” or some such option… I must not have realized it would be the Douglas Adams method of “notification”.
On the plus side, the website is just barely functional enough that I was able to avoid hours on hold, hours which I can now use to whine about MNSURE online. I imagine I’ll be back to whine some more next year when the latest cheap insurer goes belly up and I have to fight the website again. Based on the quality of the site and the quality of the provider’s communications I can only assume the actual insurance, should I ever need it, will be of the same quality (so I’m expecting that if I ever make a claim, you’ll just mail me a brick).
And 2015:

Yay, it’s that time of year again when I have to use your horrid mnsure website, because flavor-of-the-year cheapest insurance company has raised its rates (at least this one stayed around for more than a year). And as usual, I get to do the annual dance with forgotten passwords and locked out accounts. Since there are no email contacts on the site to deal with the inevitable problems, I get to decide: is it more useful to spend 20 minutes on the phone, or 20 minutes looking up the personal email addresses of the board of directors so I can whine at them? (I actually managed to get access to my account this year with only two calls to customer service, which is a new record)

Please consider some of the following changes to the mnsure site:

1. Back off on the level of login security. My bank has less security than this, and I actually care if someone gets into that account. If someone is masochistic enough to sneak into my mnsure account then they’re welcome to it.

2. Make the “Get Help” button actually do something instead of a 404 error (specifically on the Password Reset Failed page)

3. Provide a contact in case of locked account. Right now it just says “The user account is locked or disabled. Please contact the System Administrator”, but doesn’t have a way to contact this mythical creature.

4. Make the password challenge questions something that anyone can remember, I don’t want to have to call my parents every time I need to log in, to ask what city they met in. I guess orphans or children of single parents aren’t eligible for MNSURE at all.

5. Have an email contact for help. I don’t have time to call the 800 number.

6. Just publish a list of insurers and prices on the front page, which is pretty much the only reason I go to the stupid website.

7. Do something useful with the “Notifications” part of the account. It’s hard to find, doesn’t make any sense, and doesn’t actually notify me of anything.

8. Do something useful with the rest of the account. I seem to have access to such pages as “Home”, which says “No messages”, even though I have unread notifications, “Payments”, “Activities”, and “Enrollments”, all of which are blank (so what are these sections for? Am I enrolled in something? Do I make payments?), “Applications”, which has some mysterious applications with no information (I apparently have to go to “Notifications” for actual information about applications), “Contact Information”: blank. “Notifications”: Appears blank at first but eventually offers cryptic PDF files. “Appeals”: Blank, and of course, “Assister” (apparently some special person who the state has to pay to decipher the website, because they forgot to pay the programmers or testers to make sure normal people could use it). Maybe you could provide some sort of guide or walk-through of what all these weird blank pages are supposed to be for, and why anyone would ever need to use them?
9. Delete the whole site and replace it with something more useful to the public, like an animated gif of a dancing potato.
By the time I managed to get into my MNSURE account this year (about a week after starting), I’ve forgotten why I wanted to, and even if I knew what I was looking for, I doubt I’d be able to find it.
And most recently; the letter sent to the board of directors and my congresspeople in 2015:

Hello, I’m writing about MNSURE, the state healthcare exchange under the Affordable Care Act. I was a supporter of the ACA, but am deeply disappointed in Minnesota’s implementation of the exchange system. I’ve been using the service and their website since it began, and have been repeatedly frustrated and inconvenienced by it. I would like to see an overall reform of the MNSURE website, either a total remodeling, or abandonment altogether and a move to the Federal system (I have no experience with the Federal system, but I expect anything at all would be better than what MNSURE currently offers).

I am a Computer Science graduate with professional IT experience, and have learned the importance of testing, end-user experience, and reliability when it comes to a website or software product. The MNSURE website displays none of these characteristics.

For example:

-The user interface is terrible. Upon login, users are pipelined into an application regardless of their reason for visiting the site. Finding the status of completed applications requires searching through an obscure subsection of the site which is not easy or obvious. Sections of the user account appear blank and/or do not have their purpose explained. Accessing account settings or other information is not intuitive. The layout is also awful, with outdated design elements like nested frames and gratuitous white space more appropriate to the late 90s than something programmed in 2013.

-The site seems geared towards driving users away from itself, and into the hands of telephone “Assisters”. It constantly offers to connect me with an Assister, to the point where I suspect it serves only to keep them employed. When I’ve attempted to contact MNSURE staff regarding website issues, they have also suggested I use an Assister, and shown little or no interest in making the website a usable resource. I am honestly not sure why the website exists, as it is nearly unusable by the general public (or even IT professionals such as myself). I realize there is a portion of the population who will not use any website, and will always prefer a call center. However, I wish MNSURE would realize that there is a portion of the population who avoids call centers, and will always prefer a website. I am one of the latter group. My day is structured in such a way that I do not have time to call in and sit on hold, but I do have time to use a website or online application (as long as its functional).

-There seems to have been little to no testing done, either in the pre-release development, nor during the 2+ years the site has been live. I have reported various bugs and issues to MNSURE in the past but have not seen any fixes or changes made. Certain sections of the site have broken links, HTTP 403 errors randomly occur, data is slow and/or unreliable to load, and the site seems unable to handle the expected number of users. During the application process I am told I qualify for discounts, then later I am told the discount is $0.00, 0%. On occasion I have completed an application, reached a “Congratulations” page on the site, then been informed months later via snail mail that I didn’t actually complete an application. The website gives the impression of having been programmed very hastily and without any quality control or follow-up maintenance.

-There is no obvious tech support contact or way to report issues or concerns. It is not clear who, if anyone, maintains or updates the site. I’ve started to assume it was programmed and then abandoned with no updates or maintenance done over the last 2-3 years. It feels like the state paid $12 million for the server, set it up in a closet somewhere, turned it on, and forgot about it. There are a few emails listed on the site, but I’ve never gotten useful responses from them regarding ongoing website issues. There seems to be a phone number I could call regarding the website, but I’ve never had time to try it.

-The site gives the impression of high security, but unfortunately this is to the point of inconvenience. Signing in takes several steps and is slow to load. Password resets are difficult, and security questions are not applicable to many users. Some of the few options for security questions include “where did your parents meet?” (what about orphans?), “What was your grandfather’s occupation” (which Grandfather, at which time in his life?), “Where would you like to retire” (what if I don’t know?)  and “What was the model of your first car” (what If I’ve never owned one?). There are so few choices for security questions that I am forced to pick at least one that I literally cannot answer. Despite all of these hoops to jump through with imaginary password security, I have zero confidence in the back-end database, encryption, or authentication. I can only assume these things were programmed just as poorly as the rest of the site. I fully expect that anything I enter into MNSURE will eventually be leaked online if it has not already (I notice that employees have already managed to leak private information: http://www.inforum.com/content/mnsure-looks-reassure-minnesotans-after-information-leak).

Just recently I read an article about MNSURE misusing $500,000 worth of Federal Grants for remodeling their office: http://www.startribune.com/mnsure-to-refund-500k-in-grants/362427261/ This frustrated me greatly, as I could imagine several ways that $500,000 could have been spent on the website. For example, 10,000 person-hours of Quality Assurance testing at $50/hr (hey, I just gave you an hour’s worth for free!). Or perhaps they could hire a full-time tech support person for 5 years with $100k salary. Or maybe a year of enterprise-level database hosting? It could even save money in the long run, if MNSURE put money towards creating a functional website instead of cushier office chairs, they could downsize their staff into a smaller office (with fewer chairs!) and pay cheaper rent and fewer salaries.

Overall, I am very disappointed with the incredible waste of money that is the MNSURE website (and I suspect, the entire organization). As an experiment in state-run healthcare exchange, MNSURE has failed. As an alternative to the federal system, it has failed. In performing any useful purpose in exchange for the tax money spent on it, it has failed. After nearly 3 years of failure, something needs to be done.

I would love to see the people responsible for the website fired (or, if they were contractors, barred from future MN government contracts). I would also love to see the entire MNSURE site erased, deleted, and replaced with something even fractionally more functional and user friendly. Failing that, it would be great to see an outside review, testing, and revamp of the site so that it can be used by Minnesotans in the way it’s intended. It would be amazing if the site were a legitimate way to purchase health insurance, and not just a neglected failure that confuses and frustrates people.

Thanks for your time and consideration.

Yours,
Gabe Emerson
St. Paul, MN

Finally, here’s some contact info pulled from government documents and other sources (I was not able to find emails for every board member). Share your love of MNsure with these fine folks:
MN Congresspeople: http://www.gis.leg.mn/OpenLayers/districts/
MNsure Board of Directors:
Allison O’Toole
MNsure CEO
allison.l.o’toole@state.mn.us
Pete Benner
MNsure Chair / Independent Consultant
pete.benner@state.mn.us
Kathryn Duevel, MD
MNsure Vice Chair
kathryn.duevel@state.mn.us
Tom Forsyth
General Mills VP of Global Communications
tom.forsythe@generalmills.com
Phil Norrgard
Fond du Lac Band of Lake Superior Chippewa Director of Human Services
Phil.Norrgard@fdlrez.com

Media contacts:

Shane Delaney, Director of Marketing & Communications
651-539-1365 / Shane.M.Delaney@state.mn.us

Joe Campbell, Deputy Director, External Relations
651-539-1334 / Joseph.J.Campbell@state.mn.us

Other MNSURE-related emails:

publicfeedback@mnsure.org (sometimes responds to emails)
outreach@mnsure.org (community outreach)
webmanager@mnsure.org (for website ADA issues?)
AEO@MNsure.org (for ADA issues)

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