The already troubled Hawai’i Health Connector is heading into its most critical stage in the Obama administration’s health care overhaul without permanent leadership.
The Connector’s executive director, Coral Andrews, announced Friday she is resigning from the state’s problem-plagued health insurance exchange effective Dec. 6.
Her resignation comes at a critical juncture as the nation prepares for major provisions of President Barack Obama’s Affordable Care Act to take effect, the most controversial of which is a mandate that most Americans get health coverage or face tax penalties in 2014.
An executive search for a new permanent head could take months, leaving the organization in limbo as it enters the phase of signing up residents for health insurance before a Jan. 1 deadline.
"It’s going to be hard to find somebody who can run an organization like this. You’re running a nonprofit, quasi-public start-up entity. It’s very difficult," said Connector board member and treasurer Cliff Alakai. "We are going to try to find somebody as soon as possible, but we’ve got to get the right candidate. They’re not easy to come by. It’s not an easy job. I don’t know too many people who’d qualify and would want the job."
Tom Matsuda, the state’s Affordable Care Act implementation manager, will fill in as interim executive director beginning Dec. 9 while the board searches for Andrews’ replacement.
"I am not going to be throwing my hat into the ring for a permanent position. I made that very clear to the board," Matsuda said. "I’m just trying to help out with the transition."
Senate Health Committee chairman Josh Green (D, Kona, Kau), said he has serious doubts the Connector will be able to find an appropriate hire in such a short time frame.
"The success or failure of the Connector will likely hinge on the speed with which they can find a strong executive to lead them forward," Green said. "These next 60 days are absolutely critical. They’re going to have to put their heads together and fill this void very quickly. Whoever is hired is going to have to come up to speed very quickly and have very significant expertise. I don’t know if they’re going to be able to find that person as fast as they’d like, and that’s going be a significant challenge."
The Connector, an online health insurance marketplace designed to match low-income residents with subsidized coverage, is heading into what Andrews herself considers the heaviest time for enrollment in December.
Consumers must enroll in health plans by Dec. 15 for coverage that begins Jan. 1.
"I’m disappointed that she would leave at this critical juncture," Green said. "We need better results going forward than we’ve gotten so far. I’m not satisfied to date. I know it’s been a titanic job and a good-faith attempt has been given. But people need a product that works 100 percent, not 90 percent and certainly not with so few enrollees."
About 340 consumers had signed up for coverage via the Connector as of Thursday, according to the latest Connector figures. Andrews has said she expected to enroll as many as 300,000, including an estimated 100,000 uninsured, over the next few years.
Andrews, who was paid $175,000 a year, said in a conference call with reporters Friday that she was not forced to resign.
"This is my choice," she said, adding that she recommended to the board that it was time for a leadership transition.
"The Hawai’i Health Connector has been one of the most challenging, yet fulfilling, roles that I’ve had in all my years in health care, particularly here in Hawaii in the last 25 years," said Andrews, who has been executive director since December 2011. "Hawai’i Health Connector has been my baby. It has required constant nurturing and attention. The Connector has reached a point where I now need to let go and let someone else take charge."
"It’s incumbent upon leaders to assess what is needed for their organization at various stages of maturation," Andrews said. "I’ve focused on building our organization and getting it to this point of functionality. I also felt it was the right time to transition before the holidays."
Andrews, a retired Navy captain and nurse who previously worked at the Healthcare Association of Hawaii, discussed the high-stress nature of the job with board members a few weeks ago, according to Alakai.
"The pressures of the job was a lot for her and she was starting to burn out," he said. "She really worked hard for about two years. She built an organization from nothing. She started saying, ‘You know I’m really getting burned out … I think it’s time I take a break.’
"We’ve reached a plateau in the organization. She launched the Connector. There’s still some bugs that need to be fixed, but she took us from zero to where we need to be in the first level. In my opinion, she did a tremendous job."
The Connector’s website, where consumers can compare plans and enroll for health insurance under Obamacare, was supposed to launch on Oct. 1 but did not go live until Oct. 15 due to software problems. Hawaii was the last state in the nation to go live with health plans on the exchange.
Andrews is the first director of a state marketplace to leave her post since the online marketplaces were launched nationwide, according to a report by the Washington, D.C., newspaper The Hill.
