Beginning in January 2014, Hawai‘i residents who are without health insurance, small businesses, and those who are self-employed will be able to be covered by insurance purchased through an online marketplace known as the Hawaii Health Connector. The Connector was established by the state Legislature in 2011 to offer health plans to the public under the Affordable Care Act.
After more than $200 million in federal dollars, the Hawaii Connector was last in the nation to provide plan information. It has a long way to go to become the reliable and consumer-friendly organization that Hawai‘i deserves. Equally important, it must be able to sustain operations without federal funds in 2015 — just 14 months away.
AARP wants the Connector to succeed, but as of the beginning of November its website was minimally functional. Navigation is cumbersome and tools consumers need are lacking. To be consumer friendly, the website needs to add major features such as:
- tools to assist in understanding plan choices
- quality of care information, including quality ratings for hospitals, physicians and other providers
- patient experience information that allows patients to rate their providers
- complaint data
Accountability and transparency are major concerns. The Connector was created by the Legislature as the only private, non-profit exchange in the nation. It allowed HMSA, Kaiser, and Hawaii Dental Service to have voting board members despite clear conflicts of interest. The concept was championed by Sen. Roz Baker of Maui. Arguments were that a private entity, freed of the restraints of government bureaucracy, would be more nimble and cost effective.
But as a private entity, the Connector is not subject to the State Sunshine Law. In an attempt to remedy this lack of openness, Sen. Les Ihara introduced SB 830 that would have required the Connector to comply with open meeting and notice provisions. The bill was held in the Consumer Protection Committee, chaired by Sen. Baker, and it never saw the light of day.
During the informational briefing to the Legislature on October 9, there were lots of outreach anecdotes. Consumer outreach and education is critical. The Connector Board should take the lead on a specific outreach plan to reach Hawai‘i’s 100,000 uninsured residents.
The deadline for all exchanges in the nation to be self-sustaining is rapidly approaching. Sustainability is a federal mandate and the Connector needs to deal with it quickly. An early Connector estimate put its 2015 operating costs at nearly $16 million. It needs to identify revenue to match. The Connector Board needs to provide the direction and pull out all stops to become sustainable. There must not be any last-minute surprises. The Connector has to come through. After a huge investment in federal tax dollars, Hawai‘i’s taxpayers must not be asked to pay the difference in 2015 and beyond or — worse yet — bailout the Connector by making it a state agency.