$100M to help QUEST expand

» 29,000 more people would receive health coverage with the new federal Medicaid funds
» Gov. Lingle praises the funding approval as a step toward boosting charity care

The state's QUEST health program will be expanded with federal approval to provide health care insurance for an additional 29,000 low-income Hawaii adults and children.

Eligibility rises, premiums drop The Centers for Medicare and Medicaid Services: » Approved a 50 percent increase in income eligibility for the state QUEST program. Families who make up to 250 percent of the federal poverty level -- about $4,637 a month for a family of four -- can now qualify. » Approved lower monthly premiums for children of families earning more than 250 percent of the federal poverty level. A family making 251 percent to 265 percent of the poverty level would pay a $15 premium. The cost would be $30 for those earning 266 percent to 280 percent more than the federal poverty level, and it would be $60 for families with income between 281 percent to 300 percent higher. A family making more than 200 percent of the federal poverty level would have had to pay $60 in the past. Source: State Department of Human Services

More than $100 million in new federal Medicaid money is expected in the next six years to cover most of the health care costs for the new QUEST members, state Department of Human Services officials announced yesterday.

Direct payments also may be made to hospitals to offset costs of treating uninsured patients.

"The renewal and expansion of state health insurance takes us a step closer to our goal of ensuring everyone in Hawaii has health care coverage," Gov. Linda Lingle said in a news release.

"The approval will also increase our support for the hospitals that are serving people without insurance or health care coverage."

Charity care for patients has been a big factor contributing to a financial crisis for Hawaii's hospital industry, according to a recent study for the Healthcare Association of Hawaii.

Rich Meiers, president and chief executive officer of the association, which represents hospitals and other health facilities, said he has not heard details of the new federal agreement with the Department of Human Services.

"We will learn more about it next week," he said. "But obviously, anything that will alleviate the over $100 million in charity and uncompensated care provided by our hospitals last year alone is welcome news, and we applaud the governor and her staff for their efforts to bring in additional federal funds to the state."

The state administration requested a lump sum payment from the Centers for Medicare and Medicaid Services last year to help defray high hospital costs of treating uninsured patients.

Federal funding from the agency allowed the Department of Human Services to pay $7.5 million to 15 private hospitals and $2.15 million to the Hawaii Health Services Corp. last September.

The funds to Hawaii Health Services Corp. went to 12 public hospitals to cover a shortfall from July to September for low-income patients with Medicaid health insurance.

The Department of Human Services said it will continue to cover the Medicaid shortfall at the public hospitals for the rest of this year with an estimated $6.45 million in new federal funds.

Under a six-year agreement with the state, the Centers for Medicare and Medicaid Services approved QUEST's expansion to up to 20,000 uninsured low-income adults and 9,000 more children.

"The waiver approval represents an important milestone in Gov. Lingle's efforts to reform and enhance the reach of the state's Medicaid program, including QUEST, to ensure that Hawaii is able to meet the growing health care needs of its population in a fiscally responsible manner," said state Human Services Director Lillian Koller.

The QUEST program now provides health insurance for about 164,000 residents -- 65,000 adults and 99,000 children.

Adults eligible for QUEST health insurance through Medicaid earn less than $910 a month, the Department of Human Services said in a news release.

The Centers for Medicare and Medicaid Services approved a 50 percent increase in income eligibility for the state health program, allowing families to qualify who make up to 250 percent of the federal poverty level (about $4,637 a month for a family of four).

In past years, family income for the Medicaid program could not exceed 200 percent of the federal poverty level to be eligible for free insurance for their children, department officials noted.