As members of the Legislature who worked throughout the session with all stakeholders on reshaping the Hawaii Health Connector, we are troubled by president and chief executive officer of the Hawaii Medical Service Association Michael Gold’s recent call to dismantle the health insurance exchange.
HMSA is one of two health insurers participating in the health insurance exchange and its representatives have been intimately involved in the formation of the Connector from Day One.
With the legislative session recently concluded, it is very disappointing to hear the CEO of HMSA calling for the shutting down of the Connector. During the long and arduous legislative session, state lawmakers were extensively briefed by all stakeholders on the Connector, by the governor’s department heads, the attorney general and HMSA on how to restructure, reform and right-size the health exchange.
Mr. Gold calls for the removal of the Connector’s Small Business Options Program (SHOP) as an unnecessary middle man and encourages small businesses to enroll directly with HMSA.
But this "direct enrollment" solution virtually eliminates competition in the marketplace by denying Hawaii businesses and residents the opportunities to "shop and compare" and choose a health plan that’s right for them, leaving only the "big boys" to dictate that choice.
Having a robust SHOP is an essential element to the Connector’s sustainability and allows employees and employers to compare plans to see what works best for them.
Moreover, the assertion that these waivers exist and that the Legislature did not pursue them is simply not true. On Feb. 4, we wrote to our congressional delegation asking for the very same waiver that Mr. Gold alluded to, and we were told, in no uncertain terms, that we would not be able to secure itm.
We also drafted a House resolution asking for a waiver and were told again that we would not be able to get permission.
Through the legislative process, we learned that the only way we could secure a federal waiver was through the innovation waiver process, which is why we passed House Bill 2581 that will set up a task force to develop a plan to seek the waiver.
Mr. Gold also stated that the Legislature did not ask the right questions regarding the Health Connector during our deliberation on the bills.
During this past legislative session, all of the information that we received from the Connector reflected the views of its board of directors, which included Jennifer Diesman, an HMSA vice president.
Moreover, in all of the briefings, never did HMSA’s representative question the route or the line of questioning being asked.
It seems strange that at the same time HMSA is asking for a rate increase of nearly 13 percent; at the same time that the bill removing HMSA from the board is going to the governor for his signature, that HMSA now suddenly questions the need for a health exchange.
These new developments push us to the next part of health care reform that needs to be taken up by elected officials — taking a closer look at what’s really driving the costs of health care here in Hawaii.
There are some who would have us do nothing but hand the problem off to Washington, D.C., or to big insurance corporations. If we do, we run the risk of losing all the gains we’ve made under our Prepaid Health Care Act. And that has always been our main concern: the protection of Hawaii’s Prepaid Health Care Act.
Despite our differences, we believe that is also Mr. Gold’s ultimate goal, and we remain open to discussing with him his concerns and how we can, together, ensure that end for the benefit of all of Hawaii.