March 31, 2014, is a milestone date for Hawaii and the nation. It marks the deadline of the first open enrollment period for individuals under the Affordable Care Act (ACA). And it’s an opportunity to consider if there’s a better way to provide health insurance that recognizes the uniqueness of our islands.

This is the time for us to ask the question that goes to the heart of the ACA’s mission: Can we do better for the people of Hawaii?

I think the answer is yes. In fact, I believe conditions are right for truly universal health care coverage in Hawaii at a fraction of the cost of our ACA experience. We can ensure a broad safety net to provide our residents with the security that comes with health care coverage and take positive steps to control health care costs. Those are goals we all can support.

According to the National Association of Insurance Commissioners, about 7 percent of our 1.4 million people lack health care coverage. While it represents tens of thousands of people who don’t have the security of health care coverage, it’s still one of the lowest rates in the nation.

We’re doing as well as we are because Hawaii already has a progressive insurance law that goes back to 1974. It’s the Hawaii Prepaid Health Care Act and it works. So as we look at ways to reach the goal of universal coverage, it’s important that we protect the Prepaid Health Care Act and build upon it without an expensive ACA system that at best only replaces some of Prepaid.

We can accomplish this if the state requests federal waivers from certain ACA requirements that recognize our unique insurance market.

Another step is to better understand who in Hawaii doesn’t have health coverage and why. The most recent data on Hawaii’s uninsured is from the 2006 update of the Hawaii Uninsured Project. It’s critically important that we have current information to make the best decisions on how we can reach the goal of universal health care coverage.

I’d like to suggest that everyone in health care work with the state to update the uninsured project’s findings from eight years ago. Together we can then develop a comprehensive, data-based statewide outreach plan to identify and get coverage for our uninsured residents.

Let’s not forget that we have made much progress over these past few months. We know, for example, that thousands of our fellow residents registered for QUEST coverage, or Medicaid, with the state Department of Human Services. Over the past four months, HMSA QUEST has enrolled more than 18,000 members.

The goal of universal coverage in Hawaii is closer than we think. We can achieve it by forging a strong partnership between the state government and Hawaii’s health insurance industry. HMSA is ready to work with our state leadership to make Hawaii the national leader in health coverage.

I know we can do it. And I know, for the benefit of all Hawaii residents, that we must do it.