Hey, the state exchanges are doing great! At spending money, anyway. The state of Hawaii, which was supposed to have one of the easiest tasks in the country handling a state where the rate of coverage was already highers than average, spent $120 million … and has only signed up 4,300 people in four months:
Hawaii already had one of the highest insured rates in the nation as the result of a 40-year-old state law requiring employers to provide coverage. The state received more than $205 million in federal money to build a health insurance exchange to serve those still uninsured.
Yet four months after enrollments began, the Hawaii Health Connector has allocated $120 million while signing up only about 4,300 people for health plans — fewer than any other state. Despite officials’ initial hopes of enrolling tens of thousands of Hawaiians, only 400 employers have applied for plans for their employees.
In case you’re wondering, that comes to $27,907 per sign-up. That’s not the only math involved, either. If Hawaii got $205 million in federal grants for the exchange and spent $120 million of it, where’s the other $85 million?
The LA Times compares this to Colorado, where Washington only spent $26 million, but the state exchange signed up 68,000 consumers. Neither of these figures come with a breakdown of the sigm-ups between Medicaid and private-insurance plans, though, nor a representation of how many paid for their initial premium and confirmed enrollment. Did this just reach a few of the Medicaid-eligible Hawaiians? How many of the private insurance plans sold (if any at all) went to younger, healthier consumers rather than others that will seriously distort the risk pools in the state?
Given that the web site was built by CGI Federal, we probably won’t know those answers for months, but that’s not the only problems with transparency in Hawaii. Thanks to the structure built by the state, even legislators won’t be able to get answers to find out what happened to the money:
Most states operating independent health exchanges have placed them under direct state control or created strong legislative oversight, but Hawaii established its exchange as a separate nonprofit agency, rendering the details of its daily operations largely invisible to even the state Legislature. Lawmakers, who have no power to compel budget information, have struggled for months to get basic financial information or even an explanation of how the Health Connector will remain viable when federal grant money runs out this year. …
Frustration over the lack of transparency into the Health Connector’s operations has led 20 House lawmakers to sign on to a bill, scheduled for another hearing Wednesday, designed to strip it of its nonprofit status and place it under the control of the state. But that move is facing resistance from lawmakers who fear the state will be saddled with the Health Connector’s increasingly apparent financial problems and absorb its potential legal liabilities.
So far, the legislature still won’t act to take over Hawaii Health Connector, which means Hawaiians — and everyone else — will continue to wave aloha to their cash go down the drain for very little in results. With the effective end of open enrollments arriving in a month, it appears that Hawaii would have done better just to buy insurance coverage for the 4300 residents with the $120 million wasted on the web portal — and a few thousand more with that other $85 million that appears to have gone nowhere.
Update: Jim Geraghty has a great roundup of other ObamaCare train wrecks coming out of the states.