The nonprofit assigned to establish Hawaii’s new health insurance marketplace expects to enroll as many as 300,000 island residents, including 100,000 who are uninsured, by the end of next year.
Hawaii Health Connector, the state’s online insurance exchange and first major piece of President Barack Obama’s signature health reform law, will start a public awareness campaign Monday with television, radio and print advertising. The ads will explain the advantages of signing up for health insurance through the Connector, which will offer subsidized plans to most Hawaii residents.
Hawaii is one of 15 states setting up its own health insurance exchange to match qualified individuals to subsidized health plans. Under the Patient Protection and Affordable Care Act, also known as Obamacare, all Americans must have health insurance by Jan. 1 or face tax penalties.
Connector executive director Coral Andrews said in an interview Wednesday that the Hawaii health exchange would be ready for business on Oct. 1, when open enrollment begins.
“We are running like hamsters in a wheel,” Andrews said as the Connector enters the last six weeks before the start date.
Obama hopes outreach efforts by states, subsidized plans and potential penalties for not signing up will persuade the uninsured population to buy health coverage. About 75 percent of Hawaii residents should qualify for subsidies that will make the insurance more affordable, Andrews said.
“It’s not acceptable to me that 100,000 people are uninsured,” Andrews said.
But reaching the uninsured, many of whom tend to be poor and less educated, or young adults indifferent to health coverage, is a daunting task.
“I think it’s really pie in the sky,” said Gary Lee, a Honolulu-based principal with Mercer, a human resources and benefit plan consultant. “I think the people who are running the exchange are very idealistic.
I just think that those numbers are overly optimistic.
I don’t see these undereducated and unconnected people reaching to find out more information about the Connector.”
In addition to the advertising campaign, the Connector recently identified 34 community organizations who may be eligible for $6.7 million in grants to contact uninsured individuals and assist them in signing up for health coverage.
“I don’t see the grass-roots people reaching out to contact these people,” Lee said. “How quickly can they be staffed and trained to do that?”
Andrews says she and her staff of 50 are focused on getting people to come to the exchange. It’s the goal of the state to make the public aware of how to access health insurance and how affordable it can be, she said.
“If everything was perfect, we wouldn’t have 100,000 uninsured,” Andrews said.
Andrews is a retired Navy captain who had a career as a Navy nurse and health administrator before taking the $175,000-a-year job as head of the Connector, which she describes as similar to a startup technology company.
“We are a nonprofit that sits astride health and IT (information technology),” Andrews said.
The Connector aims to build a website similar to Travelocity, that will make it easy for customers to compare dozens of health plans, calculate their subsidies and enroll in a plan they select.
The Connector is doing in 11⁄2 years what most companies would need three years to accomplish, Andrews said.
A multilingual call center is scheduled to open Sept. 15 to answer questions about the Connector.
The advertising and marketing campaign will focus on hypothetical situations that many of the uninsured face, including ads aimed at younger people who may think they are invincible and don’t need health insurance, as well as a family of four that previously couldn’t afford insurance because they have a child with a pre-existing medical condition.
“We are putting a tremendous amount of thought into being authentic” in the ad campaign, Andrews said. “We’ve tried to package relevant individuals into characters that bring those stories to life.”
Hawaii has received about $205 million from the federal government to establish the Connector, educate the public on how it works and operate it in the beginning. The federal funding is only for the startup phase. Federal law requires state exchanges find other sources of funding by 2015.
If the Hawaii exchange is successful in signing up 300,000 people, it could generate $300 million to $1 billion in revenue, some of which would be used to maintain the exchange after federal funding ends. The exchange board, which is appointed by the governor, adopted a budget this month that includes a 2 percent fee on premiums to pay for the continued operation of the exchange.
“We’re working towards sustainability as a goal,” said Connector spokesman Brian Fitzgerald. “We’d like to see 300,000 enrolled on the exchange by 2015” to help achieve that goal.
Andrews said she is not planning to go to the state Legislature for funding.
Other alternative revenue streams Connector officials are discussing include community investment via philanthropic organizations or organizations that reinvest in the community, selling other products on the exchange such as long-term care insurance, as well as leasing the Connector’s technology to other states that haven’t set up their own exchanges.
The Hawaii Medical Service Association, one of the two insurers along with Kaiser Permanente Hawaii that have agreed to offer plans via the Connector, criticized the 2 percent fee on premiums. HMSA officials said the fee will increase costs to consumers instead of making health insurance more affordable.
Andrews defended the fee, saying it is one of the lowest in the nation.
The 35 states using a federal exchange, instead of setting up their own exchanges, will charge a 3.5 percent fee, she said. Only Idaho charges a lower fee, she said.
As for complaints that the Connector will lack competition if only HMSA and Kaiser are offering plans, Andrews said there are a number of other interested companies who may join the Connector.
