A report card on MNsure reporting

Obamacare hit the news headlines April 1 by meeting the Obama administration’s goal of enrolling 7 million people by the March 31 enrollment deadline.  Casually read the Twin Cities’ news this week and you might think MNsure—Minnesota’s Obamacare exchange—achieved similar enrollment success.  You’d be wrong. 

Nationally, 7.1 million people—2.25 percent of the population—enrolled in private insurance coverage through Obamacare exchanges.  As CNN explains, “The law also includes expanded Medicaid insurance for the poor in many states, but those participants are not part of the sign-up total.”  By comparison, Minnesota enrolled 47,000 people in private insurance coverage, about 0.87 percent of population.  That’s ZERO-point-eight-seven percent.  This is well short of Minnesota’s enrollment goal of 78,829. 

And while there is an important caveat to making a direct comparison between Minnesota and the rest of the country for reasons discussed below, Minnesota enrollment is not even close to the 121,959 Minnesotans that would be enrolled if Minnesota met the U.S. enrollment rate of 2.25 percent.  It’s also well short of our neighbor Wisconsin which hit 71,443 enrollees a month ago

Nonetheless, major news reports gave Minnesota’s enrollment the same glowing headlines given to the federal government’s far superior enrollment numbers.  Over at the Star Tribune, the headline reads “MNsure exceeds sign-up goal.”  At the Pioneer Press, “MNsure enrollments hit 169,251.”  And over at Minnesota Public Radio (MPR) News, “Enrollment push helps MNsure sign up 169K Minnesotans by deadline.

“What?  What’s with this 169,000 enrollment number when only 47,000 enrolled in private insurance coverage?” you ask.  Well, remember how the people who enroll in Medicaid are not part of the federal government’s goal to enroll 7 million.  MNsure and the Dayton administration do include Medicaid.  About 47,000 Minnesotans enrolled in private coverage and 122,000 enrolled in public health care programs, which brings MNsure to their wildly successful 169,000 enrollees. 

As I explained last week, lumping the private and the public enrollment goals together “conveniently hides the private coverage shortfall.” And the private coverage number is the number that matters for at least two reason. First, insurance exchange financing depends on private coverage and, second, the insurance market pool depends on enrolling young and healthy people in private coverage through the exchange.  That’s why the Obama administration focuses on enrollment in private coverage.

The Dayton administration, however, picked a different enrollment benchmark than the Obama administration and, in doing so, hid the fact that MNsure failed to meet their enrollment goal.

Behind the headlines, most reporters did an okay job reporting on controversies over the MNsure enrollment numbers.  However, nobody seems to have picked up on the fact that the Dayton administration conveniently chose a different scorecard than the Obama administration. 

Oddly, and maybe reassuringly, the headlines were more accurate last week when MNsure claimed to meet its enrollment goal early.   The headline at Rick Kupchella’s BringMeTheNews.com put it this way, “MNsure meets its enrollment goal, with some caveats.”  Similarly, the headline for an MPR article written by Bob Collins reads: “MNsure reaches health coverage enrollment goal, sort of.”  Elizabeth Stawicki’s headline at MPR read, “MNsure hits enrollment goal; most opt for government program.” The headline for Christopher Snowbeck’s article at the Pioneer Press directly highlights the private plan shortfall, “MNsure passes 135,000 enrollment target; commercial plans lag.

Snowbeck offered the most in-depth analysis.  He explained how Minnesota private plan enrollment lagged the rest of the country and reported how it’s difficult to make an apples to apples comparison between Minnesota and other states.  These comparisons are difficult because Minnesota offers a public health plan to lower-income families and working adults who would otherwise be getting private coverage in many other states.

Politics in Minnesota is the only news outlet to offer a report focusing on the other side, the Republican side of the story.  That story was written by James Nord, who has provided hands down the most in-depth reporting on MNsure’s travails at MinnPost.com.