Almost 26,000 Adults Meet Income Requirements but Cannot Access
Removing Enrollment Cap Could
Boost Hawaii’s Coverage
Rate by 21 Percent
An estimated 26,000 adults meet the income requirements for QUEST
but are not enrolled, according to a 2003 study conducted by the
University of Hawaii Social Science Research Institute. Obstacles
are varied and may include: a cap that limits the number of enrollees;
a lack of knowledge about available programs; language or cultural
barriers; and system barriers that make enrollment difficult such
as complex forms.
In a separate study commissioned by The Hawai‘i Uninsured
Project in September 2003, results affirm that the general public
values health coverage and there is a willingness to share responsibility
for providing that coverage among the uninsured, the insured, taxpayers
In terms of take up or anticipated enrollment rate, 67 percent
of the uninsured stated that they would enroll in a government
sponsored-program if they learned they were eligible. Only 16 percent
of the uninsured stated that the program would have to be free
in order for them to consider applying. In addition, regardless
of the respondents insurance status, the majority surveyed expressed
a willingness to accept a tax increase to ensure access to health
coverage for Hawaii’s people. The statewide general public
telephone survey of 18 to 64 year old residents was conducted by
Enrollment Cap Is Biggest Barrier to Access. In 1995, state budgetary
constraints resulted in changes to QUEST’s eligibility criteria.
Income requirements became more restrictive. An enrollment cap
of 125,000 people was set. As a result, QUEST is at capacity and
is not open to certain adults – despite the fact that they
meet the income requirements.
Income and asset requirements differ depending on the applicant’s
situation and household size. In general, the income requirement
for eligibility is 100 percent of the FPL (federal poverty level).
In 2003, this translates to an annual income of about $11,000 for
an individual and $21,000 for a family of four.
Open Access Regardless of Enrollment Cap. Certain classes of individuals
are guaranteed access to QUEST regardless of the cap, and can have
higher incomes such as pregnant women, who are eligible at 185
percent FPL. Children (in families up to 200 percent FPL) are also
eligible regardless of the enrollment cap.
Frequently Asked Questions
What is Hawaii’s QUEST Program? In 1994, Hawaii expanded Medicaid coverage through a managed-care
program called QUEST.
QUEST provides health care coverage comparable in most ways to
private health insurance. In addition to covering people who receive
federally funded welfare assistance, the program covers low income,
What is Medicaid? Hawaii’s
QUEST is a Medicaid program. Medicaid is a health insurance program
for certain individuals that is funded and administered through
a state-federal partnership. Medicaid provides medical assistance
for certain individuals and families with low incomes and few resources.
Eligibility is limited to individuals who fall into specific categories.
Although the federal government establishes general guidelines
for the program, the Medicaid program requirements are actually
established by each state. Whether or not a person can be eligible
for Medicaid depends on the individual’s state of residence.
What’s the Difference between QUEST and Med-QUEST? QUEST
is the name of the heath coverage program. Med-QUEST is the name
of the program’s administrative office.
For more information on the State of Hawaii’s QUEST program,
Other Examples of Government-Sponsored Health Coverage
Medicare. A national health insurance program for people
65 years of age and older, certain younger disabled people,
and people with kidney failure.
Medicaid Fee For Service. A state/federal program that
covers services for those age 65 and older, and those
certified as blind or disabled.
TRICARE. A national health care program for active duty
personnel, their families and retirees.
Uninsured Project has assembled a committee of community leaders
to explore these issues and develop potential solutions for increasing
enrollment in government-sponsored programs.