by Andrew Walden

Must Hawaii taxpayers and ratepayers pay millions to keep the delegation from having to ask President Obama for a politically embarrassing Hawaii Obamacare exemption?

The Star-Advertiser March 2, 2014, opined, “Don't spend state funds on Connector” and explained:

» Hawaii's senators and representatives should start networking with other states struggling with insurance exchanges. Together they should push hard for an amendment that would allow a limited opt-out as soon as possible.

The Affordable Care Act (ACA) does include a provision for state waivers, but those don't become an option before 2017. This date needs to be pushed up as early as possible. Even if the federal funds can be used past this year, Hawaii can't keep this agency running as is beyond 2015.

» Whether Hawaii needs an exchange at all is in doubt, and congressional leaders need to collaborate with state lawmakers on ways to shrink the whole Connector footprint.

 HNN April 1, 2014 reported:

The governor plans to push for a waiver, that could, for instance, give the departments of Health, and Human Services broader range to facilitate insurance for residents. He said, "I think in retrospect if we simply allowed the Department of Health and Department of Human Services to run it through Medicaid, and added personnel I think we probably could have registered more."

Flash forward six weeks.  The Legislative session is over.  Neither the Legislature nor the Governor stepped up.  And, riding the latest wave of Obamacare rate hikes and operating losses, HMSA CEO Michael Gold belatedly senses the danger.  In a May 9 statement, Gold points out:

Hawaii’s situation is unique. Thanks to our current insurance laws, which have been in place for more than 40 years, all Hawaii companies must provide health insurance for employees who work more than 20 hours a week. The cost to keep the Hawaii Health Connector open, as a place for businesses to buy health insurance, far outweighs the benefits.

Hawaii can save significantly by having businesses go directly to health insurers. HMSA is set up to meet that demand. Efficiently and economically. Spending millions of dollars for the Hawai'i Health Connector to act as a middleman for the business market doesn’t make financial sense.

We need the governor to seek a waiver from the federal government this year. Hawaii can make an excellent case why it doesn’t need the SHOP (the online health plan marketplace for businesses). If we wait until 2017, when the Affordable Care Act says states can apply for waivers, millions more will have been spent unnecessarily.

There are benefits to having an online marketplace for individuals because of the tax subsidy.  If not the Hawaii Health Connector, then the federal exchange. The amount of individuals who signed up for a health plan through the Connector justifies the individual marketplace. The same can’t be said for the business side.

But in an angry response to Gold, Hawaii State Reps Mc Kelvey and Belatti, and State Senator Roz Baker let the cat out of the bag.  It turns out that Hawaii's Congressional Delegation is blocking any application for an early waiver:

…the assertion that these waivers exist and that the Legislature did not pursue them is simply not true. On Feb. 4, we wrote to our congressional delegation asking for the very same waiver that Mr. Gold alluded to, and we were told, in no uncertain terms, that we would not be able to secure it.

We also drafted a House resolution asking for a waiver and were told again that we would not be able to get permission.

Through the legislative process, we learned that the only way we could secure a federal waiver was through the innovation waiver process, which is why we passed House Bill 2581 that will set up a task force to develop a plan to seek the waiver….

Why would Schatz, Hanabusa, Gabbard and Hirono seek to stick voters with millions of dollars of rate hikes and more taxpayer waste in an election year?  The Star-Advertiser May 18, 2014 has the answer:

Gold advocates that the state pursue a waiver now, rather than waiting for 2017, when the law provides for state "innovation waivers." Private insurers have their own corporate interests at heart when they push to remove the "middle man," but Gold is right that the exchange is not a good fit.

And although an accelerated pursuit would be a heavy lift politically, the top-tier leaders of the state -- the governor and our congressional delegates -- must find a way to override the health exchange requirement, or at least to scale it back, for the public good....

State legislators say they inquired about a pre-2017 waiver and were rebuffed. There may be an aversion to pushing this point -- Hawaii is the president's home state. Seeking a waiver from his signature law during an election year will start a political narrative the Democratic leadership would find awkward.

But the public interest, not politics, has to be the overriding concern.

How much is your family paying to protect the National Democrats from “awkward political narratives”? 

How much more will you have to pay in a futile effort to hide the fact that Obama’s signature achievement is a miserable failure?

Who will put the public interest above partisan talking points?

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The Awkward Narrative you must pay to hide: Hawaii to be First State to Dump Obamacare Health Exchange?