Even though MNsure officials saw countless technological red-flags in the lead-up to the Oct. 1, 2013 launch of the online health insurance exchange, Gov. Mark Dayton wasn’t alerted to those issues until a few weeks before the website opened for businesses.
That’s according to interviews with Dayton and other MNsure officials conducted by the Office of the Legislative Auditor during a year-long investigation into what went wrong with the multi-million website. The auditor released a scathing report on MNsure’s first year of operations last week.
One of the biggest questions surrounding MNsure’s troubled roll out has been how much Dayton knew about the website’s problems and when.
According to notes from Legislative Auditor Jim Nobles’ interview with Dayton, he requested a discussion with MNsure officials in mid-September of 2013, a few weeks before the website launched.
“Up to that point, he had been under the impression that exchange development was going well,” Nobles’ interview notes state. “The Governor said that when he heard in the meeting about the concerns that remained regarding the exchange, ‘it alarmed me and upset me.'”
After that, Dayton required daily calls with MNsure officials, including former Executive Director April Todd-Malmlov.
Despite coding problems that prevented MNsure officials from testing the website on real consumers before Oct. 1 as they had hoped, “As October 1 approached, Todd-Malmlov ‘gave encouraging signs,” Dayton told Nobles.
There were internal discussions at MNsure about whether to postpone the site’s launch, and Dayton told Nobles that “whether to launch the exchange was ‘[Todd-Malmlov’s] call.'” Dayton was under the impression that the go-live date was non-negotiable.
After MNsure launched, its behind-the-scenes problems became very public. Dayton told Nobles that “he wishes there had been a way to shut down the exchange for six weeks to fix all the problems.”
Dayton also said that he had grave concerns about MNsure’s customer call center. According to the interview, Dayton conveyed those concerns to Todd-Malmlov and was told MNsure was adding more staff. Nevertheless, Dayton didn’t see the situation improving.
Despite ongoing issues, Dayton didn’t lay down the law publicly until December of 2013, when he wrote a letter to IBM-Curam, the company hired by MNsure to build part of the exchange and whose software was producing the most problems.
According to testimony provided by MNsure Board Chair Brian Beutner, conversations about getting Dayton involved began in November. Beutner said that nothing happened after that conversation.
“So we’re sitting there in December and… [IBM-Curam] is not being responsive,” Beutner told Nobles in April, 2014. “And I’m like, call their CEO…It’s a big contract. You are the governor. The CEO will take your call… have the governor call the CEO and say, ‘this just doesn’t work. Make it friggin’ work.”
At that point, Todd-Malmlov drafted a letter outlining Curam’s problems, and Dayton made the call.
By his own admission, Dayton played a hands-off role in the early days of MNsure’s development. He told Nobles that “he didn’t feel sufficiently expert in the topic of health insurance exchanges to second guess most of what they proposed,” according to notes from Dayton’s interview.
But there was a critical moment in the initial stages of creating MNsure when Dayton voiced his concerns over a decision that Nobles said was ultimately one of the biggest problems with MNsure – the limited role of the state’s information technology agency in the website’s development.
For instance, MN.IT was excluded from decisions about which vendors to hire and from managing them, according to the Legislative Auditor’s report.
And ultimately, legislators passed a bill that effectively exempted MNsure from MN.IT’s authority with the idea that it would allow the website to get up and running faster.
Former MN.IT commissioner Carolyn Parnell told the Legislative Auditor that Todd-Malmlov was adamant that MNsure be exempt from MN.IT’s authority, though she never completely understood why. (Todd-Malmlov declined to speak to the Office of the Legislative Auditor.)
“They wanted to operate on their own,” Parnell said.
The issue was so contentious that Parnell, Todd-Malmlov and other state officials met with Dayton to make their cases in January 2013, as legislators were gearing up to write a bill that effectively created MNsure.
“[Dayton] said I’ll sleep on it overnight,” Parnell told the Auditor. “Well, the next day the governor says no exemptions.”
Parnell said legislators had a different view. She told Nobles that legislators “bought in to” Todd-Malmlov’s view.
The interviews also reveal new details about Todd-Malmlov’s departure as MNsure’s top official. In mid-December, 2013, she abruptly resigned.
According to Beutner, he and other board members felt she and other executives at MNsure may not have the chops to move the project forward.
“There’s so many operational issues that need to be addressed that we need to bring a CEO in to be looking not only at addressing those, but how do we position for the rest of open enrollment for the future,” Beutner said. “Every time we talked to [Todd-Malmlov] about development plans, it was ‘we’re busy through the end of open enrollment… and I kept saying, ‘that’s too late to being talking about what we’re doing for the fall [of 2014].”
One of the top people being discussed to take on the role of MNsure CEO was Department of Human Services official Scott Leitz, Beutner said.
To start the process of installing a CEO, the board requested reviews of [Todd-Malmlov] and other MNsure executives in the fall of 2013. Beutner said the reviews were not necessarily meant to make the case to fire someone, and that he still saw the need for Todd-Malmlov’s skills set.
But Beutner said Todd-Malmlov “stonewalled” the process.
When Todd-Malmlov left December, Leitz was immediately named MNsure’s CEO.