After more than $200 million in federal dollars, the Hawaii Health Connector was last in the nation to provide medical-insurance plan information. It has a long way to go to become the reliable and consumer-friendly organization that Hawaii deserves. Equally important, it must be able to sustain operations without federal funds in 2015 — just 14 months away.
Today’s Connector is minimally functional. Navigation is cumbersome and tools consumers need are lacking. To be consumer friendly, the website needs to add major features. These were identified in a national study commissioned by AARP in 2011 and provided to the Connector last July.
Features should include:
» Tools to assist in understanding choices. There are 95 plans on the site. People using the site may be faced with the daunting task of checking out two-to-three dozen applicable plans. This needs improvement.
» Quality of care information. Quality ratings for hospitals, physicians and other providers should be available. Right now, all plans are automatically rated 4 (on eventual scale of 0 to 4) as a default since ratings are not yet available.
» Patient experience information. Patients should be able to rate their providers.
» Complaint data. The insurance commission has this and it should be public.
» Other consumer information. Price information for most hospitals is online. That needs to be linked to the Connector site.
Accountability and transparency are major concerns. The Connector was created by the state Legislature as the only exchange operated as a private nonprofit in the nation. It allowed employees of HMSA, Kaiser and Hawaii Dental Service to be voting board members despite clear conflicts of interest. The bill was championed by Sen. Roz Baker of Maui. The arguments were that a private entity, freed of the restraints of government bureaucracy would be more nimble and cost effective.
But as a private entity, it is not subject to the Hawaii Sunshine Law. In an attempt to remedy this lack of openness, Sen. Les Ihara introduced Senate Bill 830 that would have required the Connector to comply with open meeting and notice provisions. The bill was held in the Consumer Protection Committee chaired by Baker, and it never saw the light of day.
The public deserves more than "a glitch" as the reason for missing the Oct. 1 deadline. Was the board aware of the situation? When? Who was accountable? What were the consequences? Where was the Legislature as the deadline neared?
Other questions remain. Of the 34 assister organizations announced by the Connector, only 12 are on the website. Where are the rest and what are they doing in terms of enrollment? During the informational briefing to the Legislature on Oct. 9, there were lots of outreach anecdotes. They need to be replaced with hard enrollment numbers. Standardized weekly reports need to be created to chart progress toward that goal of enrolling the 100,000 uninsured and they need to be public.
In spite of assertions by Connector staff that there is "lots of time," there is little in the race to 100,000 enrollments.
AARP wants the Connector to succeed, but the 2015 deadline for all exchanges to be self-sustaining is rapidly approaching, and the Connector needs to deal with that quickly. An early estimate put its annual costs at nearly $16 million. Like any other private entity, it must generate enough revenue and contain costs to be sustainable. Revenue is tied directly to its success in enrolling people. The Connector has to come through. After a huge investment in our federal tax dollars, Hawaii’s taxpayers must not be asked to pay the difference in 2015 or — worse yet— bail out the Connector by making it a state agency.
