Worst in Nation Hawaii Health Connector Looking for Another $28M
by Andrew Walden
Good money after bad?
Ranked last year as "worst in the nation," with sign-up costs estimated at $56,819 per enrollee, the Hawaii Health Connector is begging Legislators for another $28 million. The sales pitch? A financial plan which openly states the Connector will lose money for another eight years.
The Connector is set up as a State-mandated non-profit organization with insurance company representatives on the Board of Directors. The unique setup allows the Connector to evade Hawaii's public records laws, but Hawaii's lone Republican Senator Sam Slom argues the "$28 million in 'debentures' ... are in reality General Obligation bonds. Their issue by a private non-profit is unconstitutional...." On March 25 the House Consumer Protection and Health Committees agreed, yanking the funding mechanism from the bill and leaving the details for the House Finance Committee to work out in a hearing now set for Wednesday April 8 at 2pm in room 308. UPDATE: FIN passed SB1028 un-amended--it is headed for a referral to Conference Committee.
At the February 15 deadline, the Health Connector touted 13,356 sign-ups in the three-month enrollment period--but as many as 7,700 are Micronesian immigrants forced off Medicaid and into plans provided by the Health Exchange. Estimated to save the State $20 million per year, the move alarms Dr. David Derauf of the Kokua Kalihi Valley clinic. In a February 26 column in the Honolulu Star-Advertiser, Derauf points out:
"As a result of these changes, many will suffer serious consequences to their health. Some will die.
"For this particular group of lawfully present immigrants, the state under Medicaid currently pays 100 percent of the costs of the program, which ensures that low-income people have access to medically necessary care at no cost.
"By transferring them to a Connector plan, much of the state's cost will shift to the federal government, which provides significant insurance subsidies for people near the poverty line.
"However, even with those subsidies, an individual will still have to pay up to $2,250 in copays and co-insurance in a single year -- an impossible amount for someone working 40 hours a week at minimum wage and earning only $1,343 a month. At these income levels, seemingly insignificant copays can prevent people from getting the medications and treatment they need."
Kelii Akina, President of the Grassroot Institute explains: "Before the Affordable Care Act, Hawaii had a workable public-private partnership that ensured 93% healthcare coverage for the population. It was a model that other states were studying and planning to implement in some form without a federal mandate. Now consumers as well as the state government are facing skyrocketing costs."
Other populations are being suggested as forcible Obamacare converts. A bill offering benefits to "innocent" ex-convicts includes lifetime health care "...provided that the claimant enrolls in the Hawaii health insurance exchange...." With labor negotiations ongoing, Governor David Ige is suggesting putting the State's 40,000 employees into the Connector.
While reaping the benefits of Micronesian misfortune, Connector officials talk up the State's 60,000 new Medicaid enrollees--signed up not by the Connector but by the State Department of Human Services. While the Connector managed to waste $205 million on its failed enrollment software, the State DHS blew another $144 million on balky Medicaid signup systems leading to the February ouster of the State's Medicaid Director. Both efforts ended up relying on human enrollment workers to complete applications.
Says Slom: "I serve on the Connector Oversight Committee. When I seek fiscal answers I get double talk. The enrollment figures are bogus. The business plan is flawed. The Connector depends on endless subsidies and has lost millions of taxpayer dollars in questionable contracts. The Connector must be dis-connected now."