Improving the safety net within our healthcare system is indeed a sensible goal — a healthier community benefits us all.

That's what makes the state's new insurance program a good idea. QUEST-ACE is designed to provide insurance coverage for up to 20,000 "gap group" adults — typically the working poor, often with part-time jobs, who don't earn enough to pay for private insurance programs, but whose incomes make them ineligible for existing state programs.

To qualify, income cannot exceed twice the federal poverty level: A single adult could not earn more than $23,520 a year; for married adults, the income cap is $31,512 per household. The more realistic income requirements are part of some positive changes made by the state Department of Human Services that take effect in midJanuary. In addition to doubling the income cap, the plan was opened up to include adults with children, and those certified as blind or disabled. And the $60 monthly fee for those who are self-employed was also nixed, leveling the playing field for small vendors, struggling home-based business owners and more.

The coverage is provided using federal funds — part of a $100 million allotment over the next six years that also pays for reimbursing hospitals that suffer losses for providing charity care, and for expanding coverage in a separate insurance program to cover 9,000 additional children.

"We are grateful that the federal government is allowing us to double the income limits for our QUEST-ACE (Adult Coverage Expansion) health insurance program," said DHS Director Lillian Koller. "This change, along with other improvements to QUEST-ACE, will bring us closer to our goal of providing access to quality health insurance for all Hawai'i residents."

The plan is solid. QUEST-ACE coverage includes outpatient physician visits, hospital stays, emergency room services, dental and prescription drug coverage as well as mental healthcare. It also wisely includes language or interpreter services, a much-needed benefit for those for whom English is not a first language, or who have limited English-speaking skills.

There are some things to work on. For example, enrollment forms should be made available in other languages, something Koller said her department is committed to doing.

And there are concerns from some users who say finding a physician who takes QUEST is not easy. For her part, Koller said her staff takes those concerns seriously. "They need to report it to us, our staff manages our QUEST plans to make sure we get what we pay for, and that our clients get what they deserve."

One reason for the reluctance might be an outdated perception, Koller said. Prior to 2002, physicians faced additional paperwork and a challenging process for reimbursements, prompting some to forego accepting the plan. But there are encouraging signs. Since November 2002, electronic claims and a more standardized process have made things more palatable, she says. It's a matter of getting the word out.

The benefits to insuring this "gap group" are clear. Insurance will encourage early, preventative care — easing the strain on painfully overcrowded emergency rooms, which are the main route for the uninsured, who often put off seeking treatment until the illness has progressed or pain becomes intolerable. That, too, makes treatment far more expensive t.han if it had been caught early on. In fact, hospitals estimate they collectively lose roughly $150 million each year providing care to the uninsured, or to the underinsured whose bills simply don't get adequately covered.

And improving access to healthcare is no small matter: "Access to healthcare allows people to be better educated about their own well-being. If they are able to come in and take care of these health issues, then they are better able to care for themselves and their families," says Paula Yoshioka, executive vice president and chief administrative officer for The Queen's Medical Center.

It's good to see sensible efforts to address the lack of health insurance. It moves us all that much closer to the laudable goal of providing health insurance for all — and that's something we can all be proud of.