The state’s two largest health plans are pointing the finger at Obama­care for significant losses in the first quarter.

Hawaii Medical Service Association said more than $62 million in premiums collected will be used to pay an Affordable Care Act insurer fee to the federal government this year, in addition to $4.9 million in other costs related to the law, also known as Obama­care. The ACA fee insurers must pay the federal government jumped about 40 percent this year, HMSA said.

The insurer fee by law must be recorded at the beginning of the year and was "the primary reason" the health plan recorded a loss of $57.2 million in the quarter ended March 31, up from a $30 million shortfall in the year-earlier period, HMSA said.

"Obamacare is primarily insurance reform, so I’m not surprised it’s affecting HMSA," said Eric Mais, health care finance expert at the University of Hawaii Shidler College of Business.

Kaiser Permanente Hawaii, which is both an insurer and provider, reported $11 million in Obama­care fees and taxes in the quarter and posted a loss of $7.8 million, up from a year-earlier deficit of $5.9 million.

The ACA fees, based on premiums collected, pay for subsidies for low-income families and individuals to purchase insurance coverage on the Hawaii Health Connector, the troubled online insurance marketplace.

The Affordable Care Act is reforming the way insurance works and requiring consumers to obtain coverage. The theory is that if everyone has medical insurance, they are more likely to detect illness early and avoid high-cost chronic diseases, slowing down escalating health care costs.

In the last 15 to 20 years, the cost of health care has risen at three times the rate of inflation, which is about 2 percent a year, Mais said.

"That’s the economic promise of this," he said. "Preventing disease is much less expensive than treating it later."

However, the law is "disrupting the insurance companies’ standard business model," he added.

"Insurance companies in general are usually pretty profitable and are pretty good at mitigating financial risk," Mais said. "I think the insurance companies are going to be fine in the long run."

But in the short term, insurers — prohibited from refusing to cover individuals with pre-existing health conditions — likely will justify the need for raising premium rates for consumers because of the additional costs related to the law, he said.

While HMSA blames the majority of the first-quarter loss on Obama­care, it attributes some of the bleeding to members using more health care services and the rising cost of prescription drugs.

"Unfortunately, the money that our members paid to cover their health care wasn’t enough to cover the total cost of their doctor visits, prescription drugs, and other health-care services, and the cost of administering their benefits," said Steve Van Ribbink, HMSA’s chief financial and services officer, in a news release. "Health care is advancing at an astonishing rate. Innovative specialty drugs are providing new treatments and therapies. But these drugs come at a high cost and we expect that cost to continue growing."

HMSA, which had 726,889 members at the end of the quarter, collected $727.3 million in premiums, up from $707.9 million in the first quarter of 2014. It paid out $656.4 million for medical benefits, up from $636.3 million. Administrative expenses totaled $127.7 million, up from $108.2 million, resulting in an operating loss of $56.9 million, up from a shortfall of $36.5 million in the year-earlier period. Investment gains totaled $2.4 million, down from nearly $6 million. After taxes the insurer’s loss was $57.2 million. HMSA’s reserve, used to pay for unexpected costs for members, fell to $350.4 million from $364.1 million.

HMSA said it is modifying drug policies and the way it covers prescription medications "to make sure that our members and employers can continue to afford the care they need."

In addition, the insurer is investing in programs to help members improve their health to avoid the need for expensive drugs, hospitalization, specialized treatments and other medical services.

Kaiser’s revenue totaled $320.3 million, up from $296.1 million, while expenses grew to $330.7 million, compared with $303 million in the year-ago quarter. The health maintenance organization’s operating loss totaled $10.4 million, up from a loss of $6.9 million. Income from investments totaled $2.6 million, up from $1 million, bringing Kaiser’s net loss to $7.8 million.

Kaiser, one of two insurers offering medical plans on the troubled Hawaii Health Connector, the state-based health insurance exchange, saw a growth of more than 8,000 members in the quarter, resulting in total membership of 239,997.

"It was a good, solid quarter," said Thomas Risse, Kaiser’s chief financial officer. "When you factor in that we had a whole year’s taxes (booked in the quarter), we broke even for quarter. Kaiser has seen strong membership growth, and we’ve had great success in maintaining a relatively low cost trend."