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Wednesday, June 03, 2015
HMSA blames Micronesians for 50% Rate Hike
By News Release @ 1:00 AM :: 5465 Views :: Health Care, Cost of Living

Obamacare: HMSA 50% Rate Hike on Individual Plans

Star-Adv: The Hawaii Medical Service Association has asked the state to approve a request to raise premiums for its individual Affordable Care Act health plans for 2016 by an average 49.1 percent, the highest rate request increase Hawaii's largest health insurer has ever made....

According to Gold, many of HMSA’s new members were previously uninsured, and often have serious health conditions that require expensive care. Health plans across the nation are increasing premiums as they face the same issue, he said.

"We’ve learned many of these members are using substantially more medical services and prescription drugs than we expected,” he said. "Now we have a much clearer understanding of the true cost of caring for these members.”

read ... Thanks, Obama

SA:  4,000 members from the Compact of Free Association, originally on Medicaid, purchased individual health plans from HMSA this year through the Connector. 

KHON: State responds to HMSA’s request to raise ACA premiums by 49 percent

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News Release from DCCA, June 2, 2015

HONOLULU – State Insurance Commissioner Gordon Ito today issued the following statement regarding HMSA’s request filed with the Insurance Division to raise premiums for individual Affordable Care Act (ACA) health plans for 2016:

“This is the highest premium increase ever requested by HMSA. The requested increase for an average of 49.1 percent for the ACA individual plan will be closely scrutinized.

“The Insurance Division will actively seek reductions to the proposed request, where possible, to ensure fairness to all parties involved.

“If medical expenditures paid out for healthcare services under the ACA individual plan are too high, the division’s ability to drastically reduce this requested increase will be limited.”

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HMSA: Update on individual Affordable Care Act (ACA) health plans

Dear HMSA member,  June 1, 2015

We recently filed a request with the state Insurance Division to raise premiums for our individual Affordable Care Act (ACA) health plans for 2016. Our request for an average 49.1 percent increase is the highest premium increase we’ve ever asked for. It’ll affect about 3 percent of our membership and will cover the much higher than expected medical costs for these members.

At HMSA, we understand the frustration of rising health care costs. We’re a local company that employs more than 1,600 Hawaii residents. We care about all of our members who are often our family, friends, and our neighbors.

Our decision to ask for this premium increase was truly difficult. We explored every alternative for a smaller premium, but ultimately had to ask for this increase for several important reasons:

  • Almost everyone in Hawaii already has health insurance from their employer, Med-QUEST, or Medicare. The small number of people left without coverage often had serious health conditions. Many of these previously uninsured people purchased our ACA plans.
  • ACA plans began in 2014 and are still new. This is the first time we’ve been able to price these plans using actual claims and health information from these members. We’ve learned many of these members are using substantially more medical services and prescription drugs than we expected. Now we have a much clearer understanding of the true cost of caring for these members.
  • This year, several thousand members from the Compact of Free Association (COFA) community purchased individual ACA health plans from HMSA. These members came to us from the state Med-QUEST program and we’re honored to serve them. However, many of these members have conditions that will likely require intensive medical services and expensive prescription drugs.

The ACA has helped thousands of Hawaii residents get health coverage. That’s good for the well-being of our state. But it comes with a price that we’re seeing now.

We’re not alone in asking for a large individual ACA plan rate increase. Other health plans around the country are reporting premium requests as high as 51 percent, as you’ll see in this CBS News story.

It’s important to remember that if you receive your health plan through your employer, an Akamai Advantage plan, or a pre-ACA health plan (also called a grandmothered or grandfathered plan), this premium increase won’t affect you.

If you have an ACA plan, your premium won’t change this year. The new premium won’t start until 2016.

I know this is a lot of information to take in. As always, we’re here to answer your questions. You can visit an HMSA Center or office, or call us at 983-7280 on Oahu, or 1 (844) 230-0427 toll-free on the Neighbor Islands, Monday through Friday from 8 a.m. to 5 p.m.

Thank you for choosing HMSA. Serving you is our privilege.


Michael A. Gold
President and Chief Executive Officer

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Flashback February, 2015: State Saves $27M by Forcing 7,500 Micronesians into Health Connector

SA: Micronesian migrants living in Hawaii under the Compact of Free Association are no longer covered by the state for Medicaid, but they are being enrolled for health insurance through the Hawaii Health Connector. This  will save the state an estimated $27 million dollars.

In this legislative session, Hawaii lawmakers also introduced a pair of bills that would require the state to cover the costs of premiums, copays and deductibles to help low-income migrants.  The Senate health committee advanced SB1327 in mid-February....

There are an estimated 7,500 migrants affected by the health insurance changes. SB1327 seeks an estimated $8 million to cover the additional health care costs.

The bill has support from large medical entities like Hawaii Medical Services Association, the state's largest insurance company, and The Queen's Health Systems.

  *   *   *   *   *

Flashback April, 2015: "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."

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