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The Honolulu Advertiser
Posted on: Tuesday, April 18, 2006

Avoid disruptions in QUEST healthcare

We like having choices in a democratic society. Programs that broaden the options for the public are good ideas unless they also impose consequences that have precisely the opposite effect.

Such is the case with the state's plan to compel enrollees in QUEST, the health plan for low-income residents, to re-enroll within 60 days or be automatically assigned to one of several competing health plans.

None of us ever likes being told we're being automatically enrolled in anything. Imagine a patient turning up at a doctor's office and, because he failed to fill out a form, learning that he'd been routed to a different plan, with different physicians.

Even given the grace period the state would add, this could disrupt services unnecessarily. Several measures that seek to block this program are moving at the Legislature.

The motivation for the state's action is to open doors for new, competing health plans. That's an admirable goal, but it might be achieved without the widespread confusion that automatic enrollment could cause.

Here's how: All QUEST enrollees are Medicaid beneficiaries. And as a result of a congressional deficit-reduction act, Medicaid beneficiaries must provide proof of citizenship or lose their coverage.

The state Department of Human Services, which administers Medicaid benefits in Hawai'i, is planning an intensive outreach program to help those in Medicaid locally with presenting the documents required as proof of citizenship. Officials say they plan to do this by tapping a network of social service agencies that can help beneficiaries with the paperwork.

At the same time, these social workers could present the Medicaid beneficiaries with their QUEST options. It's a much more user-friendly way of giving people a choice in their healthcare than simply mailing them instructions to mark a return postcard with their selection.

And without automatic enrollment it would generate traffic for any new player in the health plan market.