A view of the US Capitol in Washington (AP File Photo)
A view of the US Capitol in Washington (AP File Photo)

HONOLULU – Hawaii Reporter has obtained a copy of the testimony that Tom Matsuda, the Interim Executive Director of the Hawaii Health Connector, will present on April 3 to the House Committee on Oversight & Government Reform, the Subcommittee on Economic Growth, Job Creation and Regulatory Affairs and Subcommittee on Energy Policy, Health Care and Entitlements during a hearing on “Examining ObamaCare’s Problem-Filled State Exchanges.”

See the full testimony here: Matsuda-HI

Matsuda, who has been the interim director since December 9, said as of Sunday, March 30, some 7,242 individuals enrolled in commercial health insurance through the Connector for both the Individual and SHOP with 281 employers participating in the SHOP Marketplace.

That’s compared with the governor’s estimate that “hundreds of thousands of people” would enroll, and the Connector’s prediction that at least 50,000 people would enroll this year.

Matsuda said the state faces some significant issues, which delay enrollment.

There is currently a backlog of roughly 11,000 financial assistance applications within the Individual Marketplace that have been processed by our state Medicaid program and must be evaluated by the Connector for other premium assistance eligibility, Matsuda said.

“We are working to make the necessary eligibility determinations in order to process the applications that remain “in queue” at this time,” Matsuda said. “We have more than tripled the number of call center representatives and are making as many as 1,000 outbound calls each day to collect information from consumers so we can process their applications.”

The Connector’s total enrollment, to date, is low, Matsuda acknowledged, especially as compared to other State-based marketplaces.

“The Hawaii health insurance marketplace is unique. We have a small total population of roughly 1.4 million residents, with only 8% uninsured, or about 100,000 lives. Hawaii’s Prepaid Health Care Act has existed for 40 years and is largely responsible for the low number of uninsured individuals. In addition to requiring most employers to offer coverage to employees who work more than 20 hours per week, the Hawaiʻi Prepaid Health Care Act also prescribes certain other requirements that are generally more stringent than the ACA,” Matsuda said.

Also impacting the insurance market is Hawaii’s diverse population and geography, Matsuda said.

“Out of a population of roughly 1.4 million, about 10% identify as Native Hawaiian or other Pacific Islanders. There are at least 45 different Asian and Pacific Island languages spoken in the state, with one quarter of our population speaking a language other than English at home and just over half of the population is able to speak English “very well,” Matsuda said.

“Hawaii also has a unique geography, with our population spanning across seven major islands. The combination of our cultural, linguistic, and geographic diversity has posed challenges to engaging in effective outreach and education about the Marketplace. We are continuing to address this challenge and are hopeful that improvements in our strategies will facilitate greater enrollment,” Matsuda said.

The Connector also experienced “operational challenges” last fall, Matsuda said.

“The Connector, as with all of the other Marketplaces, anticipated opening for online business on October 1, 2013. On the eve of opening, it was brought to the Connector’s attention that, despite all of the testing held to date, the portal would not perform as expected. Erring on the side of caution, it was decided to delay the launch of the Connector’s portal until October 15, 2013,” Matsuda said.

The system, while better, there is still much work remains to be done, Matsuda added.

The Connector must be self-sustaining as of January 1, 2015. Currently, a 2 percent fee is assessed on every plan.

“The key to our sustainability has always been small employer enrollments in our SHOP. Due to the existence of Hawaiʻi Prepaid Health Care Act and the small number of health insurers in the state, there is little need for the average small business to use SHOP. The ACA small business tax credit is a real incentive, but few businesses may decide that the credit provides enough incentive to leave familiar insurance plans and processes they have used for many years,” Matsuda said.

The federal and state decisions to give SHOP employers the option to remain with their existing insurance plans through 2016 has also reduced the volume of potential customers, Matsuda said.

Matsuda will present his testimony at 4 a.m. Hawaii time on Thursday, April 4. The hearing will be livestreamed at oversight.house.gov

U.S. Rep. Colleen Hanabusa, D-HI, is expected to attend the hearing.