WAI'ANAE — More than 100 people showed up at last night's public town meeting to discuss the new state health plan for low-income patients who are elderly, blind or disabled.

The QUEST Expanded Access program, also known as QExA, went into effect on Feb. 1. Waianae Coast Comprehensive Health Center has not signed on. At issue is how the more than 2,000 such Medicaid patients currently being treated at the health center will be affected.

Two care service providers have been selected to manage the government sponsored QExA program: 'Ohana Health Plan, a unit of WellCare Health Plans of Tampa, Fla., and Evercare Quest Expanded Access, which is part of UnitedHealth Group, Inc.

"I want to explain why we have not signed to be a provider of these two health plans," health center CEO Rich Bettini said at the start of last night's meeting. "I'm not saying that we won't. But the decision will be made by all of us."

Bettini said he has serious concerns about how the state chose the two care providers for the QExA program.

Both are Mainland-based, for-profit plans that have had problems in states where they have operated, Bettini said, holding up a South Florida Business Journal article about how one of the companies is in the midst of a federal investigation.

Meanwhile, AlohaCare — the provider Bettini feels has been compatible with the health center's mission of providing care suited to the special needs and unique cultural aspects of the Wai'anae Coast's large Hawaiian population — had its bid returned unopened by the state Department of Human Services.

Also, he added, AlohaCare has typically been the low bidder in the past.

Early on, some at last night's gathering said they simply couldn't understand the state's reasons for the changes.

"Why?" said longtime Wai'anae resident and health center patient Franz Tatarko, 70. "What is the advantage to what it was before? No one has said. I still don't know what it's all about."

Tatarko said he's been happy with his healthcare and he doesn't want it to change.

Jackie Watson, 77, also of Wai'anae, said the health center had saved her life and that it's unfair and inconvenient that she would have to switch plans at her age.

"My first concern is that I don't want to change my doctors," said Watson. "I live on the coast. Why should I drive to some other facility when the Waianae Comprehensive Health Center is right here? Outside of Tamura's Market, this is the only convenient thing we've got on the Wai'anae Coast."

Watson said another thing that disturbs her about the plan change is that it will take money away from the state at a time when Hawai'i is reeling from the worst economic crisis since the Great Depression.

"Why did the state pick two Mainland companies to be our QUEST plan providers?" she asked.

Bettini said the health center has until April to choose one of four options: accept the new plan as is, not participate at all, wait for the passage of a compromise bill in the Legislature that would allow the health center to be part of a special demonstration project, or contract directly with the state without going through the QExA plan.

"No one's going to be turned away," he said. "We don't care if we're paid or not. It's what happens after that in the long run that we're concerned about."