Back in January, the state Department of Human Services decided to decrease the number of health plans offering Medicaid on neighbor islands from five to two plans. Under normal circumstances, this decision would disrupt the lives of nearly 50,000 QUEST Integration beneficiaries currently insured by AlohaCare and Kaiser Permanente on neighbor islands, who would have to find new health plans. It would also burden rural health care systems, which already suffer from doctor shortages and other resources issues.
But we are no longer under normal circumstances. The coronavirus pandemic has thrust 220,000 Hawaii residents into unemployment, meaning they will also lose their employer-provided health insurance. Many will not have jobs to go back to when our economy reopens.
According to Hawaii Island County Councilmember Val Poindexter, people who were already living paycheck to paycheck will likely fall into poverty and the number of new Medicaid beneficiaries is sure to skyrocket. Both the Maui and Hawaii Island county councils have approved resolutions urging the governor to delay implementation of this decision until the ramifications for all residents have been considered.
DHS has since postponed the July 1 start date for the contract change, and it remains one more uncertainty our community is facing.
Forcing these new Medicaid patients, along with the 50,000 patients who will lose their insurance under AlohaCare and Kaiser Permanente, to find new coverage in the midst of a pandemic will completely upend Hawaii’s Medicaid health safety net when we need it most. It will put the health of thousands of patients in jeopardy, at a time when our health providers — especially our neighbor island community health centers — are already stretched to their limits.
Neighbor island community health centers provide care to all patients, regardless of their ability to pay. We are already struggling with limited resources and funds as a result of the coronavirus. We worry what will happen if patients lose access to their regular providers due to DHS’ decision.
Many Medicaid patients have special needs, including chronic conditions that put them at higher risk of developing life-threatening complications from COVID-19. The Medicaid population has a higher rate of mental health issues and physical disabilities that make it harder for them to navigate a complex system of limited health care options. Even a brief lapse in coverage or delay in care could result in serious impacts to their health and lives.
We are calling on Gov. David Ige to issue a new QUEST Integration Request for Proposals designed to address post COVID-19 needs and treats neighbor island Medicaid beneficiaries equitably. We need to retain and build upon the safety net we already have in place and ensure that Hawaii’s growing number of Medicaid patients will not lose their coverage or access to their physicians.
DHS must recognize that our current situation is entirely different from the one in which it made its original decision. No one could have foreseen that our lives would change so drastically in just a few short months. What would have been a serious burden in a pre-COVID-19 world is now an unworkable and dangerous public health issue that cannot be allowed to continue.
We urge Gov. Ige to step in to ensure that DHS takes this opportunity to protect the health of all of Hawaii’s people, not just those who live on Oahu.
BJ Ott, left, is CEO of Malama I Ke Ola Health Center (Maui), David Peters is CEO of Ho‘ola Lahui Hawaii (Kauai) and Irene Carpenter is CEO of Hamakua-Kohala Health Center.