Hawaii is the only state in the nation that has failed to make medical plan prices available on its health insurance exchange, despite being one of the first to embrace President Barack Obama’s Affordable Care Act.
All 16 other state-based marketplaces now have plans available for shopping, as do the states whose exchanges are run by the federal government, according to Kaiser Family Foundation.
Many of those with prices posted are having other problems with their websites, but they have at least posted a list of policies and their rates.
"Hawaii is the only state that doesn’t have premium information up," said Cynthia Cox, a Kaiser Family Foundation policy analyst. "I’m sure that there’s a lot of demand to see the premiums on the exchange. In most other states we’ve been able to see premiums and plan information starting Oct. 1. If Hawaii’s rates weren’t up then and haven’t been up now, there might have been a missed opportunity for some people."
The Hawaii Health Connector, the online marketplace created by the federal health reform law, had planned to have its website up Oct. 1, but computer problems stalled the launch. Connector Executive Director Coral Andrews told state lawmakers Wednesday that the site would have pricing information by Tuesday.
Andrews did not respond to requests for comment Friday.
As of Friday the Connector website, hawaiihealthconnector.com, had no mention of when pricing would be available.
Many states have had trouble enrolling people on the new marketplaces because of computer glitches and the sheer volume of inquiries, but most consumers are at least able to find out the price they would pay for various plans, said Rosemarie Day, president of Day Health Strategies, who was involved in establishing the nation’s first health insurance exchange in Massachusetts in 2006.
Meanwhile, the Connector call center (877-628-5076) has stopped taking applications because of privacy issues, call center representatives said Friday, directing callers to apply via mail or the website.
By contrast, California’s exchange, Covered California, determined eligibility for more than 16,300 applicants in the first week of open enrollment, said spokesman James Scullary, adding that the website logged 986,000 unique visits in the same period.
New York announced Tuesday that it had signed up more than 40,000 residents for coverage through its online marketplace.
"It certainly is a big challenge to do all of this. You’re basically creating something out of nothing," Scullary said. "The interest across the board has been really strong. It just shows how badly people are looking for affordable health care options."
Hawaii’s two dominant insurers and only participating carriers on the exchange, Hawaii Medical Service Association and Kaiser Permanente Hawaii, have posted 2014 policy rates on their sites, but consumers must enroll on the Connector to see whether they qualify for tax credits to reduce the cost of coverage.
Some fear that while other states are moving forward even with glitches, Hawaii could be left behind.
"It may not be working flawlessly (elsewhere), but it’s at least working," Frances Miller, a professor at Boston University and the University of Hawaii William S. Richardson School of Law, told the Honolulu Star-Advertiser from her home in Boston. "There are things there for people to interact with. There’s nothing to interact with in Hawaii because they’ve put nothing up. It doesn’t make sense to me given the lead time they had. It only has two insurance companies in the mix — that’s the part that makes it hard to believe."
The Connector’s chief marketing officer, Rick Budar, told the Star-Advertiser on Oct. 1 that officials knew of the software problems preventing people from comparing and purchasing health policies several days before the launch date. But Andrews’ account differed, saying Connector officials were only made aware that rates wouldn’t be up the night before open enrollment on Oct. 1.
The Connector, created by the Legislature as a nonprofit organization in 2011, has received $205 million in federal grants, including $53 million to build and operate the website over four years.
"Who did the test runs? How could this be a surprise at the very last minute? If it wasn’t a surprise, why didn’t they give consumers advance notice?" Miller asked. "Would the same thing be happening if the state did it alone instead of this public-private partnership?"
Residents have until Dec. 15 to sign up for coverage that begins Jan. 1, the start of the federal mandate requiring most Americans have insurance or face tax penalties. Open enrollment runs through March.
