Health law still a mystery

Less than three months before the state launches a health insurance exchange for an estimated 100,000 uninsured Hawaii residents, many consumers know little about the program aimed at providing free or subsidized coverage.

There has been no mass marketing about the exchange, known as the Hawai‘i Health Connector, and how people can benefit from it.

“There is a huge educational problem out there,” said Gerry Silva, president of AARP Hawaii, which advocates on behalf of seniors. “People need to know that the opportunity (to purchase health insurance at no or low cost) is coming up. We’re less than 90 days away from the actual opportunity to enroll. This is a daunting task.”

A major provision of the federal Patient Protection and Affordable Care Act, better known as Obama­care, goes into effect Jan. 1, although individuals and businesses can shop for policies and apply for subsidies beginning Oct. 1. The open enrollment period runs through March. Under the law, uninsured Americans must get health insurance or face tax penalties.

How the new law will affect individuals depends on many factors. A 35-year-old, for example, who earns $19,000 a year and purchases a health policy with a $329 monthly premium could receive tax credits that would reduce her actual out-of-pocket costs to $67 a month.

The Hawai‘i Health Connector, established as a nonprofit entity by the state Legislature, is the place where people are to learn what policies are available and what subsidies they may get. It has received $205 million in federal grants and hired 50 employees but has yet to start an advertising campaign to educate the public.

Connector spokes­man Brian Fitzgerald said a full-fledged marketing campaign with television, online, print and radio advertisements will begin in mid-August, just a month and a half before consumers and businesses can begin enrolling on the exchange.

Connector employees have been reaching out to the public by speaking with more than 100 select community groups about their future health plan options, Fitzgerald said.

“We want to get out there with the proper and correct information at the right time to get people informed,” Fitzgerald said. “There are rules coming in and decisions being made that impact how the system works. Until those are finalized we can’t communicate a whole lot.”

In contrast, Colo­rado already has begun running advertisements and marketing campaigns to educate the public. Connect for Health Colo­rado began its mass marketing campaign in May to try to educate 400,000 uninsured in the state. It spent $1.1 million on advertisements in May and June.

“We felt like there’s a lot of confusion and a lack of awareness about the services we’ll be offering, so we felt the earlier we started to define it, the better,” said Ben Davis, a Connect for Colo­rado spokes­man.

The Hawai‘i Health Connector is spending $12 million to establish a call center and $53 million over four years on the information technology to develop and maintain the Connector’s website and operations.

It also issued a $1.2 million contract for marketing that includes market research, advertising, outreach and public relations. The campaign will run through March. The Connector hasn’t launched its website yet and hasn’t set a date for that, Fitzgerald said.

Some experts are worried the campaigning in Hawaii is getting a late start.

“They (the uninsured) are a hard population to reach. The people who are uninsured tend to be less educated,” said health policy expert Frances Miller, a visiting professor at the University of Hawaii William S. Richardson School of Law. “They’re late (educating the public) now, and they need to make up for lost time. It’s not a wise thing, and they should be doing it as fast as they can. They need to keep their eye on the ball. The ball is you want to get everybody covered as quickly and efficiently as you can.”

Seventy-eight percent of uninsured adults were unaware of new options for health insurance in a January study for Enroll America, a national nonprofit group established to maximize enrollment.

Small-business groups, medical providers and insurers have taken on the role of trying to educate the community on health care reform.

The Hawaii Medical Service Association has launched its own health reform website, run TV spots and has talked with nearly 30 groups over 10 weeks.

Obamacare has caused confusion among businesses as well, particularly since Hawaii law already requires employers to provide health insurance to full-time workers.

“There’s just so many unanswered questions. It’s just confusion,” said Tim Lyons, executive director of the Hawaii Business League, representing 900 small businesses. “Even after a day’s worth of seminar instruction by seven to eight different speakers, I was frankly just about as confused as I was when I got in. By and large, Hawaii businesses and employees for the most part have kind of let it fly by their heads. The average person and business hasn’t paid much attention to this at all.”

Martin Schiller, president of advertising firm The Schiller Agency, said the campaign will be “extremely large for Hawaii.”

“This is going to be huge to flesh out to make sure the message is correct,” he said. “How many people really understand Obama­care? Not very many people. So if you bring something like this on, it’s going to be even more confusing if they don’t lay it out properly and articulate it so that everyone understands.”