The Forgiving Democratic Electorate
There’s little consequence for a failed insurance exchange at the ballot box.
by Jim Geraghty, National Review Online, October 8, 2014 (excerpt)
The states with the four worst-performing Obamacare state health-insurance exchanges — Hawaii, Maryland, Minnesota, and Oregon — all built them with the enthusiastic, loud backing of Democratic governors and state legislatures.
One year later, there is little sign that any of those Democratic governors, or their preferred successors and allies, will suffer at the ballot box for the millions wasted on exchanges that never or rarely functioned. On paper, this shouldn’t be a partisan issue; whether you think the Affordable Care Act is the greatest piece of legislation in a generation or Satan’s handiwork, there shouldn’t be much of a constituency backing massive expenditures for online insurance shopping and purchasing systems that don’t work.
And yet . . .
The Hawaii Health Connector is on its third director in less than a year.
U.S. taxpayers gave the Hawaii state government $204 million to build the Connector system, making it one of the most costly in the nation. It failed to work properly from the beginning, and enrollment fell way below the projections, with just 10,800 people. It was expected to become self-sustaining through user fees by the end of 2014 but earned just $40,350 in its first six months, far below the $320,000 it expected. The state legislature had to step in and provide an additional $1.5 million to keep it running.
The state did add 30,000 people to Medicaid, but 75,000 Hawaiians remain without health insurance. What’s more, those who signed up may find a strikingly limited selection of options.
In August, Hawaii’s largest health insurer announced it was pulling out of the small-business side of the state’s troubled health exchange; this left only one insurance company, Kaiser Permanente, for employers. “Michael Gold, president of Hawaii Medical Services Association (HMSA), told the AP that his staff is spending too much time and money dealing with the Connector’s technical problems.”
Hawaii stands out as a state where the failed exchange may have cost an incumbent governor his job. Governor Neil Abercrombie, whose administration implemented the Hawaiian Health Connector, was defeated in the Democratic primary by state legislator David Ige in August.
Ige called the system “a disaster” in a Democratic-primary debate and pointed out that Abercrombie had appointed four cabinet members to the Health Connector’s board. The governor countered that the Connector was “a creature of the legislature.”
Hawaii may be the state with the best sign of a public backlash against the state government for the embarrassing failures.
The problems of the state’s exchange probably helped Ige in the primary fight, and both the Republican gubernatorial candidate, Duke Aiona, and former Honolulu mayor Mufi Hannemann, the candidate of the Hawaii Independent Party, are campaigning on scrapping the Hawaii Health Connector. Ige is critical of the program, but never quite calls for it to be scrapped entirely.
Polling in Hawaii is infrequent, but it appears Aiona has a shot at winning; the most recent poll put him just 4 percentage points behind Ige. Hannemann is carrying 8 percent....
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