Unusual support for bigger government

Photo: screenshot from a Hawaii Health Connector commercial.

According to a Feb. 12 U.S. Department of Health and Human Services report, just 3,614 people have enrolled in Obamacare via the nonprofit Hawaii Health Connector exchange. The number that actually paid for their policies is likely even less. Despite the fact that Hawaii has had exceptionally low numbers of uninsured individuals historically, mostly due to the Pre Paid Health Care Act of 1974, this may still be problematic for the nonprofit.

According to watchdog.org, representative Bob McDermott and other members of the House Consumer Protection Committee are considering seven different bills that would “reform” the exchange, as well as launch a state government take-over of the nonprofit at a cost of $15 million a year to maintain.

That’s an operations figure for 2015 that was mentioned by Hawaii Health Connector executive director Tom Matsuda at several legislative briefings. Matsuda also stated, however, that the figure is a rough estimate. The actual figure could end up being less after the Connector finishes three different audits: one internal, one by a federal oversight office and one by the state.

McDermott and the House republicans would normally be against such a move because of the increased state spending and, especially, because of the increased role of the state government in health care. Which is why his comment regarding the proposal surprised us.

“The exchange is already costing taxpayers $204 million, and the added bureaucracy is increasing costs for consumers and adding more layers for them to go through to get health care,” McDermott said.

The $204 million figure is the amount the Federal government gave the state to set up the exchange, which needs to be self-sufficient by 2015. The nonprofit exchange had planned to achieve this through the fees charged during the registration of some 300,000 Hawaii residents by 2015, a goal they appear to be falling far short of.

According to a spokesperson for Connector, the goal of enrolling 300,000 individuals by 2015 was an early estimate made by the previous executive director, but that the projection has since been scaled back. The uninsured population of Hawaii is between 8 and 10 percent, or about 100,000 lives, according to a report from the Hawaii Primary Care Association and another used by the State Department of Commerce and Consumer Affairs. Additionally, a number of those uninsured will be Medicaid eligible, according to a report by the Kaiser Family Foundation.

In a legislative hearing on Dec. 9, 2013, Matsuda said the new goal for enrollment was closer to 50,000, broken down as 40,000 individuals and 10,000 employees.

That employee number is important because, unlike other states which can push back the Affordable Care Act employer mandate, Hawaii has a small business health options program (SHOP), which forces the state to establish an additional SHOP exchange portal to comply with the Pre-Paid Health Care Act.

Meanwhile, Senate president Donna Mercado Kim is against a state take-over of the exchange, calling that option a financial “black hole.”

Maybe a government take over would address the “increasing costs for consumers” and decrease the “layers for them to go through to get health care,” but it’s still shocking to hear those words came out of McDermott’s mouth, of all people. This is, after-all, the same rep who says that the state Department of Education is too incompetent to create an “accurate” and “appropriate” sexual health curriculum for its high school students.