April 9, 2012; Source: InsuranceNewsNet
Under the new Patient Protection and Affordable Care Act, people without access to employer-sponsored insurance or a public plan like Medicaid could obtain coverage through a health care exchange. Those making use of this option might include people now buying their own insurance, small businesses and those receiving income-related subsidies. Some proposals even include people who have access to employer-sponsored health insurance but want greater choice.
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States are given the right to structure exchanges and Hawaii is arguably the only state that has decided that it will establish its exchange, the Hawaii Health Connector, as a nonprofit—though it has elsewhere been described as quasi-governmental, which would make it akin to Colorado’s effort. According to some, the Connector’s nonprofit status may pose a number of problems. First, it allows the board to avoid the state sunshine law in one of the most critical agencies being built for public benefit. This, according to this article, allows for choosing health care plans outside of public view.
To make matters worse, say critics, of those nominated to the Connector board, three are insurers with a vested interest in the results: the Hawaii Medical Service Association, Kaiser Permanente Hawaii and Hawaii Dental Service. The article states, “There are federal rules requiring a nonprofit to have conflict of interest guidelines and ethics provisions; however, it’s the board that gets to write them. In short, Hawaii’s nonprofit board is self-governing. It’s a situation that threatens to shut out the public and consumers.” –Ruth McCambridge