Streamlining plan will require 38,000 Neighbor Island patients to find new health insurance

Updated: Feb. 5, 2020 at 5:59 PM HST
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HONOLULU, Hawaii (HawaiiNewsNow) - Nawai Irie of Keaau on the Big Island suffers from spinal muscular atrophy, a severe neurological disease.

Her doctors initially told her parents she wouldn’t live past age 2. She’s’ now 5 and her mother gives a lot of credit to her patient advocates at AlohaCare.

“It’s like they go up to bat for you and fight for it. So I believe they have a part in extending her life expectancy," said her mother, Wendy Irie.

The girl is one of 38,000 Medicaid recipients on the Neighbor Islands who could be forced to look for new insurance. Many worry that they won’t get the same quality care and choice of physicians.

The state recently streamlined the $2.5 billion-a-year program by reducing the number of neighbor island health plans from five to two.

“We want to make sure that doctors are spending their time with their patients and not tied up in paperwork with health plans," the Department of Human Services said last month.

“We also want to make sure that health plans have room to grow and be successful.”

HMSA and United Healthcare won the Neighbor Island contracts. Kaiser and AlohaCare were left out and AlohaCare has since filed a protest that has frozen the award.

“We don’t understand how the proposal was scored and more importantly we are uplifting community voices that have approached us with concerns with the impact," said Laura Esslinger, AlohaCare’s CEO.

While AlohaCare filed the bid protest, the state’s decision also affects 10,000 Kaiser patients on Maui who are on Medicaid.

“Together AlohaCare and Kaiser serve half the Quest eligible individuals on Maui, 60 percent on Molokai and Lanai and closer to 20 percent on the Big Island," said Esslinger, whose company teamed up with Kaiser on its unsuccessful bid.

Those patients may have to find a new insurer. The state now has 30 days to grant or reject AlohaCare’s bid protest.

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