Go after the waiver

We are somewhat surprised by the vehemence with which state legislators attacked Hawaii Medical Service Association President Michael Gold for suggesting the state immediately seek a waiver to “get out from under” the Hawaii Health Connector.

Gold told The Maui News in an interview May 11 that because of the state’s Prepaid Health Care Act, small businesses don’t need the health care exchange and there are better and cheaper ways to make insurance available for individuals.

Legislators – including Sen. Rosalyn Baker and Rep. Angus McKelvey of Maui – have assailed Gold for the remarks, explaining that they had inquired about a waiver during the just completed session and were told one is not available.

Gold’s point, we believe, is that the state has not formally asked the federal government for a waiver. In lieu of the millions of dollars it will take to support the connector until waivers are allowed in 2017, it is common sense to ask now.

After all, exceptions to the law have been made throughout the implementation of the Affordable Care Act (employers’ mandate delay until 2015, individual mandate delay for many until 2016, allowing nonconforming plans, etc.). So, why wouldn’t the feds allow Hawaii – a state decades ahead of the rest of the country in providing health care – to save millions by handling individuals without an expensive exchange?

In an op-ed piece in the Honolulu Star-Advertiser, the legislators hinted that the exchange gives business more health care choices. They wrote:

“Mr. Gold calls for the removal of the Connector’s Small Business Options Program (SHOP) as an unnecessary middle man and encourages small businesses to enroll directly with HMSA.

“But this ‘direct enrollment’ solution virtually eliminates competition in the marketplace by denying Hawaii businesses and residents the opportunities to ‘shop and compare’ and choose a health plan that’s right for them, leaving only the ‘big boys’ to dictate that choice.”

The only problem with that statement is that HMSA and Kaiser (the “big boys”) are the only insurers participating in the connector. Where’s the competition? A small business has a lot MORE CHOICES if it avoids the connector and goes directly to the marketplace. (Hawaii Medical Assurance Association and University Health Alliance come immediately to mind as options not available in the connector.)

The legislators should ask Gov. Neil Abercrombie to seek a waiver now. Time – and money – are a wastin’.

* Editorials reflect the opinion of the publisher.