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MNsure shakeup: Executive Director Todd-Malmlov out, as problems and political pressure persist

MinnPost photo by James Nord
MNsure Executive Director April Todd-Malmlov, right, stepped down after an impromptu teleconference meeting of the exchange’s governing board.

MNsure Executive Director April Todd-Malmlov is out as head of the state’s troubled health exchange.

Scott Leitz
Scott Leitz

She stepped down Tuesday evening and will be temporarily replaced by senior Human Services official Scott Leitz.

Todd-Malmlov, who has led the exchange since its fledgling days at the Department of Commerce, stepped down after an impromptu teleconference meeting of the exchange’s governing board.

The move comes after numerous technical glitches have made it difficult for consumers to access accurate coverage information on the exchange, as well as problems getting customer data to insurance companies.

The issues, which Gov. Mark Dayton called “unacceptable” last week, were put in a poorer light when it came out that Todd-Malmlov and a Human Services official vacationed together in Costa Rica around Thanksgiving.

“The Board believes the organization is at a stage where it needs a CEO to manage both MNsure’s current challenges and position it for greater success in the future,” governing board Chairman Brian Beutner said in a statement distributed by MNsure.

“[Leitz] has been a proven leader at the Department of Human Services where he has managed a large and complex organization effectively,” Beutner added. “We are fortunate to have someone with his capabilities and his intimate understanding of MNsure available to step in quickly and lead us through these critical next few months.”

Leitz, who was assistant commissioner of health care at DHS, in the same statement, acknowledged that “MNsure must do better.” The governing board will conduct a national search to replace Todd-Malmlov.

The meeting that ended in Todd-Malmlov’s resignation was held in private at MNsure’s offices in downtown St. Paul.

Reporters camped outside the meeting were locked out of the MNsure office. A state spokesman came out after the meeting and handed out a prepared statement but declined to comment further on Todd-Malmlov’s resignation.

Gov. Mark Dayton wasted no time in commenting after the change:

“I commend the Members of the MNsure Board for their strong action to change immediately the executive staff leadership at Minnesota’s Health Insurance Exchange. I fully support their decision, and I have confidence in Scott Leitz’s abilities to lead MNsure as its Acting Chief Executive Officer.

“As I have said before — and have made emphatically clear to the MNsure Board — now is a critical time for Minnesotans, who are relying on this exchange to purchase good quality, yet affordable, health insurance. The recent problems some have experienced with MNsure are completely unacceptable. I am hopeful that this new leadership will lead to their swift resolution.”

Beutner, Todd-Malmlov, Human Services Commissioner Lucinda Jesson and MNsure spokeswoman Jenni Bowring-McDonough did not return requests for comment.

But Beutner and Leitz will address the move on Wednesday at MNsure’s offices at about noon, shortly before a pre-scheduled meeting of the exchange’s governing board.

Department of Corrections spokesman John SchadlMinnPost photo by James NordDepartment of Corrections spokesman John Schadl handed out a release to reporters camped outside of the MNsure office suite in St. Paul on Tuesday, but declined to comment further.

“This change will position MNsure to focus on both the short-term need to fix key technology issues and its long-term mission of enrolling as many Minnesotans as possible in affordable healthcare,” according to the statement.

DFL Rep. Joe Atkins, the chief exchange architect in the House, thanked Todd-Malmlov for her service in a statement. He added: “Unacceptable technical challenges remain for Minnesotans trying to enroll with MNsure.”

Republican legislative leaders opened the week with doubts that MNsure would be able to get consumers coverage by Jan. 1, when the full federal health reform law takes effect. State officials and the insurance companies have said that Minnesotans will get private coverage if they pay by Dec. 23, and have assured public program enrollees that they will be covered as long as they complete the necessary steps.

“Tonight’s news offers no comfort to hardworking Minnesotans who are still unsure if they’ll have insurance coverage on Jan. 1,” House Minority Leader Kurt Daudt said in a statement on Tuesday evening. “For too long, Gov. Dayton and Democrats have ignored the reality that their new state agency, MNsure, is failing Minnesotans.”

Leitz was embroiled in a controversy at the Department of Human Services earlier this year, and an internal investigation named him in a report looking into special rates for the University of Minnesota’s Amplatz hospital. A group of human services lawmakers voiced their support for Leitz to DHS shortly after the issues came to light.

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Comments (31)

  1. Submitted by Pat Thompson on 12/17/2013 - 08:38 pm.

    Very disappointing

    This is very disappointing news. Every time I’ve heard Todd-Malmlov speak about MNsure, I’ve been impressed by her grasp of every bit of the problems and the challenges. She is clearly a very able leader for a complex project like this.

    As the Strib story today indicated, she’s taken 4 weeks of vacation a year since she started with MNsure. That’s no more than a fair amount for a person with years of service and credentials like hers. And she was in contact the whole time she was away via those modern methods we have these days. It’s ridiculous to pretend people should be in the office 365 days a year for years, even when there’s a big goal.

    I despise the way our toxic politics makes us chew up and spit out public servants like her. We’ll be lucky if we can attract quality talent to work on the people’s behalf… score one for the right that wants to prove government can’t work.

    • Submitted by Richard Carter on 12/18/2013 - 09:05 am.

      Private sector comparison

      Had she been on the private side of the market, and taken such leave, there wouldn’t be any reason for her to come back. That would be pure irresponsibility.

      As for how much vacation she has taken….. Are you serious? Four weeks at year??? I don’t know of anyone who takes more than two weeks, and most I know take seven to ten days.

      With a project this critical, this complicated, this expensive; taking any vacation during a roll-out is unforgivable.

      • Submitted by Pat Thompson on 12/18/2013 - 10:29 am.

        How Many Weeks

        Seven to ten days of vacation — let’s see, ten days (assuming you mean working days) is two weeks.

        I don’t think it’s uncommon for high-level managers to have four (or more) weeks of vacation. Whether they take them or not is a matter of organizational culture, and I would argue we would all be better off if people had more vacation or at least take what they are allotted.

      • Submitted by Erik Petersen on 12/18/2013 - 10:44 am.

        Her vacation is an irrelevancy, and this focus on it is prurient. And your private sector / public sector comparison is specious here.

        I don’t think it’s obvious at all that she’s malfeasant, unqualified, or incompetent. Quite the opposite.
        You’re in IT right? MnSure is defective because it was launched prior to being completed. It’s go live date was dependant on political realities, not software development realities.

        And with this as your software development process, potential for failure is say 100%. Using this development model only occurs if you have amateur level insight or are more beholden to political requirements than functional software requirements.

        Here, fair to say both circumstances are true. But she’s no more culpable than hundreds of other social service and political leaders invested in the implementation of PPACA / MnSure.

        She’s a scapegoat.

    • Submitted by Rebecca Hoover on 12/18/2013 - 12:40 pm.

      Not disappointing … but very good news

      Everytime I heard Todd-Malmlov speak I was disgusted by her deception. While she bragged about MNSure’s great web site, the site was a dog and prevented many from enrolling. In other cases, enrollment in a policy occurred only after weeks of persistent effort.

      Likewise Todd-Malmlov bragged about the policies offered on MNSure but many are just high deductible policies that make health care basically unaffordable to many Minnesotans.

      Todd-Malmlov should have been replaced long, long ago.

      • Submitted by Matt Touchette on 12/18/2013 - 04:07 pm.

        I hope that you realize that neither Todd-Malmlov or MNsure controls what the policies are. The policies are presented by the private sector insurance firms (many being non-profits) based one the specifications required in the Obamacare legislation. While it appears you have struggled to get proper access to said policies (I’ve had trouble as well), I would argue that for some people the available policies are better than those available before and some are worse. That said, not all policies from before can be compared to those in the new system because of the rules in the new legislation. Comparisons must be taken with a grain of salt and this fact kept in mind, and I would also argue that true affordability is yet to be seen as these policies actually go into effect.

        • Submitted by Rebecca Hoover on 12/19/2013 - 02:37 am.

          Todd-Malmlov did not have to brag about these policies

          Todd-Malmlov certainly did not have to brag about the policies on the MNSure site. In fact, doing so, was a disservice to us. I am keenly disappointed that she did not advocate for affordable care. Of course, what can we expect from a former vice president at the big bad UnitedHealth Group?

  2. Submitted by David Fehlan on 12/17/2013 - 10:04 pm.

    They’re still tone deaf

    One of the reasons she got canned is the extremely poor timing of a long vacation. Now look at the MnSure “Holiday Party” flyer in the background of one of the photos above. They knew reporters were going to be camped outside of the office and yet nobody pulled the flyer.

    • Submitted by Holly Lahd on 12/18/2013 - 09:40 am.

      I work in the same building as the MnSure office. I’d just like to point out that the “holiday party” flyer in the photo is advertising the one hour holiday party with cookies and coffee hosted by building management (a private company) for all of the building tenants. In the context of the photo it appears to be a MnSure-sponsored party, but it is not.

  3. Submitted by Dennis Tester on 12/17/2013 - 10:42 pm.

    All this could have been avoided

    if Obama and the democrats had just listened to the pleas of Texas senator Ted Cruz to delay implementation for a year. But no, he was a kook and an extremist who was only trying to obstruct their wonderful plans.

    The result is the end of the people’s trust that government can ever get anything right.

    • Submitted by jason myron on 12/18/2013 - 06:35 am.

      Pleas? Please….

      Ted Cruz is STILL a kook and extremist and his grandstanding STILL has no merit. This woman deserved to be canned simply for being tone deaf enough to schedule a vacation at a critical time in the roll out of an extremely complex and revolutionary concept. As an account manager, I’ve canceled numerous plans to be around for key release and marketing roll outs through the years, not because I was asked to, but because I knew it was the right thing to do. For all of her academic success, she was sorely lacking in common sense.The implementation of this exchange and others was being watched all over the country…perception being reality, she should have known better.

    • Submitted by Jackson Cage on 12/18/2013 - 07:53 am.

      or, the other choice…

      ….would have been to implement Cruz’s plan….(cue the crickets).

    • Submitted by Matt Touchette on 12/18/2013 - 04:11 pm.

      One could argue that Cruz did not articulate his arguments effectively, nor did he have a decent alternative plan for the mean time. I would agree that an alternate plan should have been implemented and the roll-out of the exchanges should have been pushed back.

  4. Submitted by Dan Hintz on 12/17/2013 - 11:38 pm.

    Good riddance

    As someone who has spent dozens of hours trying to enroll in MNSure, I can attest to the fact that the website was, and still is, a disaster. I finally enrolled today, but only after accessing some of the information I needed elsewhere, because some of the links just kick you out of the system.

    If she wasn’t going to get canned for her incompetence, she deserved to be canned for the sheer arrogance in taking a vacation now. Props to the Dayton administration for having some accountability.

  5. Submitted by Steve Rose on 12/18/2013 - 08:08 am.


    In business and in government, it is ill advised to mislead your boss. It is key to prevent your boss from being surprised, even if the surprise can be blamed on those Republicans (finger wagging).

    I praise Governor Dayton for holding an employee accountable for failing to deliver. Washington D.C. should take a lesson from our Governor.

  6. Submitted by Dennis Tester on 12/18/2013 - 08:40 am.

    Just for a few laughs

    Go read this:

    She’s giddy with the success of the roll-out.

  7. Submitted by Richard Carter on 12/18/2013 - 08:43 am.

    Complete disaster – on soooooo many levels

    First off, this pretty well blows the election potential for the dems on the next state ballot. The fiasco(es) of the right over the last four years pale in comparison. This mess is costing many of us a lot of unnecessary expense (including myself), which has turned into a gold mine for the insurance companies.

    Second, check out who are the Board Members of MNSure. Then ask yourself, “With all the talent in this state, why were these people appointed?” Then dig just a little deeper into their backgrounds. And of those with a background even close to being related, why isn’t there any reduction on the ‘medical costs’ side of this program. (Ref: Dr. Noseworthy, Mayo Clinic; Fortune magazine, Nov 18, page 66.)

    And why did they need tens of millions of dollars in television and radio commercials, which ended up being farsical attempts at levity as compared to informational messages?

    IMO, inept, totally inept. I supported the ACA from the beginning, 100%; until two months ago when I saw how it did nothing to improve insurance rates or increase services, except for the very poor. Problem was/is, the very poor were already covered under a better, more efficient program: MinnesotaCare.

    Lesson learned. I’m not voting for either side next time around. “Jessie! Where are you???”

    • Submitted by Logan Foreman on 12/18/2013 - 04:13 pm.

      Dream on

      Everyone knows the GOP has attempted nothing to solve this pathetic healthcare system, which would only have been worse. Paying for constant Er visits and paying huge dollars to corporate health insurers is pure stupidity. Better response by you – just support single payer.

  8. Submitted by Robert Owen on 12/18/2013 - 09:35 am.

    Out of that position or out of work?

    Todd-Malmlov is out as head of the exchange. Is she still working for the exchange or some other state agency in another capacity making this merely a lateral transfer to get her name out of the light?

    Seems strange the a DOC spokesman is handing out press releases for this event.

  9. Submitted by Christopher Williams on 12/18/2013 - 09:58 am.

    Agreed. I work in IT, and I get 5 weeks of vacation a year – but I certainly don’t take it during code releases and product roll outs. We have a large number of people here with family overseas, and it isn’t uncommon for someone to take a month off, but it’s always planned so that they are not the ones leading a new product launch or the lead developer on a project launching during that timeframe.

    Accessible by phone or not, you need all hands on deck and at the battle stations for an important launch like this.

    The other thing I’ve been taken aback by are the sheer number of bureaucrats in charge of this thing. Technology people should be leading technology projects. This lawmakers should have handed off a requirements document, agreed to a design, and gotten out of the way.

    • Submitted by Richard Carter on 12/18/2013 - 10:56 am.

      Also Agreed

      I’ve been in IT for a couple of decades.

      This project, in the grand scheme of things, is not completely unique or challenging. Other projects of greater scope and demand abound, and much of the code previously written could have been accessed and adapted. At least, the developers on this project could have followed industry standards. That’s assuming the firms hired had that experience; and why wouldn’t the state seek out better vendors? On what criteria was this lead developer chosen? It is obvious that whoever was hired, missed the mark(s) terribly, including providing trained support.

      This is why you cannot depend on governments. They haven’t the expertise and worse, they don’t have the expertise to chose the best resources. This is not political commentary. (I’ve voted liberal most of my life.) All one has to do is look at the objective results and facts. It’s a mess, and we get to pay for it. Why isn’t the state cancelling the contract and asking for a total refund from the developer? I have a difficult time understanding why this isn’t considered non-fulfillment of the contract.

      As an example of how subpar the MNSure site is, I just signed up for an account. (Bear in mind, I’ve been creating websites for over 15 years.) What should have taken me 10 minutes max, ran well over a half hour, with the need to step backwards many times due to incomplete and at times ridiculous instructions. This thing is a disaster IMO.

      • Submitted by Renee McGivern on 12/18/2013 - 04:11 pm.

        Agreed as well!

        The ignorance about websites and SAS is killing this. And yet another health department insider has just been appointed. Governor Dayton, please appoint someone who’s been successful with SAS and website systems to run this.

        I was on the site this morning but gave up within 15 minutes because I realized I’ll need half a day on the site. Example: Figuring out five (really odd) security questions as I sign up. My bank doesn’t ask me five security questions. t had no idea how to answer some of them. What was my best day ever?? What is the most important date to me??

        The health department and the health insurers operate from a bureaucratic, not an entrepreneurial and responsive mindset so this was doomed. They don’t ever have to care about user experience; their minds can’t comprehend it except at a kindergarten level. Political parties have nothing to do with this.

        This saga will continue until they bring someone in who has had success with both user experience and big, complicated SAS projects. Health department experience is not helpful here; it’s hurting it. Who would ever hire long time government department heads to run a new business startup??

        Overthought. Overwrought. Over promised. Under-delivered. And we’ll keep handing them millions of dollars.

      • Submitted by Matt Touchette on 12/18/2013 - 04:23 pm.

        Richard, good commentary. These are some questions and arguments I agree with. Well said.

  10. Submitted by David Frenkel on 12/18/2013 - 03:01 pm.

    MNSure board

    It is questionable that the MNSure board approved Todd-Malvoe’s vacation. Given the various personal and technical problems the MNSure board should probably step down as well.
    I don’t buy the concept that being on a vacation in a tropical third world country means you can be in constant communication. How do you call the office while snorkeling in the ocean or hiking in a remote rain forest. This wasn’t a vacation in Chicago sitting in her hotel room.
    I also have worked decades in IT and you certainly don’t leave town on vacation when important milestones on a project are due. The concept of working remotely is not new but when serious issues arise it is often necessary to work as a team in person especially like a project like MNSure that is not only politically charged but has data privacy issues.

  11. Submitted by Rosalind Kohls on 12/18/2013 - 03:13 pm.

    Leitz not any better

    Scott Leitz will have just as much trouble with the MnSure disaster as April Todd-Malmlov did. The website is just the tip of the iceberg. The real problem lies in the Obamacare legislation and the federal government’s poor implementation of the legislation.

  12. Submitted by Tom Anderson on 12/18/2013 - 07:37 pm.

    But the Governor

    Had nothing to do with the resignation. He has made clear that he has nothing to do with the decisions being made so congratulating his administration is silly.

    The board making the decisions, however, has his stamp all over it, especially the head of HHS. He can run, but he can’t hide.

    • Submitted by Steve Rose on 12/19/2013 - 10:29 am.

      Really, nothing?

      The seven board members are were all appointed by the Governor. Yet, you would have us all believe he holds no sway; that he had no influence on the Executive Director “stepping down”?

  13. Submitted by Dan Hintz on 12/20/2013 - 01:42 am.

    Question to the IT folks

    Could this have been done right given the timeline? Is that excuse valid?

  14. Submitted by Steve Rose on 12/31/2013 - 07:45 am.

    The Governor has been closely involved.

    “I’m not going to comment on that,” Dayton said in response to a reporter’s question about whether he ordered Todd-Malmlov’s departure. “I’ve been closely involved for the last few months, and I’ve said publicly my extreme displeasure with the way MNsure was going.”

    Governor Dayton, as quoted by this MinnPost column.

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