UPDATED 5/17/11 10:40 a.m.

CORRECTION: After this Fact Check was published, Civil Beat was made aware that Neil Abercrombie formally announced his campaign for governor in March 2009. A previous version of this story incorrectly stated that his campaign began in February 2010, when Abercrombie resigned his seat from the U.S. Congress. Bearing this new information in mind, we’ve changed the grade from “False” to “Mostly True.”

Gov. Neil Abercrombie spoke about expanding Medicaid rolls during a press conference recently.

Abercrombie said: “Since I started running for governor, 18,000 children have been added to the Medicaid lists in the state of Hawaii. 18,000.”

He used the example to underscore some of the financial challenges facing the state.

But is his figure accurate?

Not according to numbers compiled by the Hawaii Department of Human Services, which tracks state Medicaid programs.

From April 2010 to April 2011, there were 6,789 more children — those defined as 19-years-old or younger — enrolled in Medicaid, according to figures provided to Civil Beat by Joseph Perez, a communications specialist with Human Services. Since April 2009, there have been 16,357 more children enrolled.


Abercrombie formally announced his campaign for governor in March 2009. He resigned from Congress in February 2010.

Since April 2009, there have been 16,357 new children enrolled in Medicaid. If you assume a 12 month average for 2009 at approximately 800 new children enrolled per month, it’s likely that since March 2009, there have been about 17,000 new children enrolled.

The number of children added to Medicaid since he resigned from Congress is about 7,000.

When asked for comment, a spokeswoman said Abercrombie was actually speaking about growth in total enrollment. She pointed Civil Beat to figures for total enrollment in Medicaid since December 2010 — not enrollment for children. The spokeswoman provided a chart from the Hawaii Department of Human Services showing an increase from 249,000 in December 2009 to 267,000 in December 2010, a total increase of about 18,000.

The table below shows the increase in children on Medicaid since 2007.

Date Children Enrolled in Medicaid in Hawaii Increase in Children Percentage Increase
April 2007 103,896 N/A N/A
April 2008 105,439 1,543 1.5%
April 2009 114,424 8,985 8.5%
April 2010 123,992 9,568 8.4%
April 2011 130,781 6,789 5.5%

While the governor’s number wasn’t accurate, his point was correct, that unpredictable growth in demand for services has made the state’s budget challenge more difficult.

Medicaid, which is administered by the Department of Human Service’s Med-QUEST division, is health coverage through managed care plans available for lower income residents.

Medicaid in Hawaii

Since June 2008, Medicaid enrollment in Hawaii has increased 26 percent across the board, according to a Department of Human Services report. About 271,000 residents take advantage of one of several Medicaid programs, according to Perez.

That’s more than one in five people in Hawaii.

“QUEST is really the traditional Medicaid program in Hawaii,” Perez told Civil Beat. “It serves children, pregnant mothers and provides the widest coverage in terms of low-income folks in that area.”

Perez said there is also QUEST Expanded Access, which serves the aged, blind and disabled populations.

There are two other programs, QUEST-Ace and QUEST-Net, which Perez described as very similar. The programs provide coverage for non-pregnant, non-disabled adults who are low income but don’t qualify for one of the other programs.

To pay for the assistance, Hawaii spends about $1.6 billion annually, half of which is provided by the state general fund and half from federal matching funds.

In order to qualify for the traditional QUEST program, Human Services lists some requirements. Recipients must:

  • be a Hawaii resident;
  • be a U.S. citizen or qualified alien;
  • have a Social Security number;
  • not be certified as blind or disabled;
  • not be age 65 or over;
  • not be living in a public institution;
  • have income not more than 100 percent of the current federal poverty line except for pregnant women and children up to age 6, who may have income up to the amounts listed above;
  • not be eligible for health insurance from your employer (except for AFDC and GA recipients);
  • have assets not exceeding the Hawaii QUEST asset limits.

The asset limits are defined as:

  • $2,000 for a household of one;
  • $3,000 for a household of two;
  • $250 for each additional person
  • Asset limits do not apply to children under age 19 born after September 30, 1983 or to pregnant women for the duration of the pregnancy

If eligible, recipients can choose one of six health-care and dental plans. For more details on the programs, look here.

The problem with the system is that it’s expanding too quickly. In fiscal year 2012, it is expected the state general fund portion of costs will reach $785 million. That would be a $179 million increase over fiscal year 2011.

In order to address the growing costs, Human Services is cutting back. Up to 4,500 people enrolled in QUEST-ACE and QUEST-Net will no longer be eligible according to new guidelines. Eligibility for adults will decrease from 200 percent of the federal poverty line — $25,710 for a family of four in Hawaii — to 133 percent. Other cuts and new packages will also be enacted.

Children and pregnant women will not be affected, however. Their services will be maintained.

Perez told Civil Beat the division administrator for Med-QUEST, Dr. Kenneth Fink, said the good news is that the increasing Medicaid enrollment numbers seem to be leveling.

“According to him, the numbers do seem like they are plateauing right now,” Perez said. “So they are not continuing to rise at the same rate of increase.”

Despite the leveling, the burden on the budget is still — and will be — immense. That’s the point Abercrombie was attempting to drive home. But while he’s right that Medicaid is a prime example of the challenges facing Hawaii, his figure was incorrect.