As of Monday, the deadline for signing up for Obamacare coverage, fewer than 8,000 Hawaii residents had successfully enrolled, among the lowest in the nation.
For the past six months Hawaii’s health insurance exchange, the state’s version of President Barack Obama’s Affordable Care Act, has been battling one problem after another in its attempt to connect the estimated 100,000 uninsured in the state with health coverage.
The deadline for getting coverage and avoiding a tax penalty was Monday. The next chance for consumers to enroll will be Nov. 15 through Feb. 15.
Hawaii Health Connector, the nonprofit that received $204.3 million to match qualified individuals with subsidized coverage under the Affordable Care Act, said it hopes to add to the nearly 8,000 currently enrolled by reaching out to those who began applications but did not complete them.
The Connector said it had 22,000 apply as of March 22. Those who applied but did not finish the process have the opportunity to complete their applications even though the deadline has passed.
Connector officials said part of the reason so many applicants did not finish the process was because of a failure on the part of the state Department of Human Services.
Anjali Kataria, the Connector’s chief information officer, said DHSâhad agreed to collect information needed to determine whether individuals were eligible for tax credits to help pay for their health insurance. DHS didn’t collect the information, and that caused a bottleneck in enrollments on the exchange, she said.
Consumers seeking to lower the cost of insurance can apply for tax credits only on the Connector but must first be deemed ineligible for Medicaid, the government insurance program for the poor, by DHS.
"One hundred percent of the applicants who applied for Medicaid and were denied were sent back to us from DHS with missing required information," Kataria said. "We had an agreement with DHS. The reality is we really didn’t know until a few weeks ago that these files were actually incomplete, and that’s why they weren’t processing."
Kataria said there are more than 11,000 Connector applicants being held up because of the problem with DHS.
DHS said it only agreed to collect information necessary to make a Medicaid determination and isn’t required to collect additional data for the Connector.
"We are using the application (the Centers for Medicare and Medicaid Services) approved," said Kenny Fink, administrator of the DHS division that runs the Medicaid program. "Our system’s working fine. The solution is to have Medicaid and tax credit eligibility done in one system."
As of February, Hawaii had the lowest number of enrollees in the nation, according to Avalere Health, a consulting firm that has been following the law’s implementation.
To fix the problem, the Connector is creating a separate self-service website portal specifically for the 11,000 applicants in limbo to complete applications.
It also has tripled call center staff to 60 from 20, including hiring more outreach coordinators to process the remaining applicants by month’s end.
"What we decided to do is hire additional staff even though it wasn’t really our fault," Kataria said. "They’re making 1,000 calls per day. We are going to process all of them as fast as possible."
Whatever the source of the problem, Connector applicants have had a hard time getting insurance.
Sheila Beckham, executive director of the Waikiki Health Center, a community health clinic contracted to sign people up in Obamacare, said the process has been distressing.
Out of 399 patients the center attempted to enroll, so far it has been able to sign up only 59 through the Connector, she said.
She initially projected the center enrolling 5,000 people.
"Obviously we learned it wasn’t working," she said. "It has been really difficult. The system was miserably set up."
