Planned cuts worry
those caring for uninsured
Health care for uninsured residents and Pacific islanders faces a crisis because of state Senate budget cuts, alarmed health care providers say.
The Senate budget changes, subject to a House-Senate conference committee, set "flat funding" for the rising uninsured population, totaling about 123,000 residents, said Beth Giesting, Hawaii Primary Care Association executive director.
The Senate also dropped funding for Medicaid assistance for about 5,500 people from Micronesia, the Marshall Islands and Palau, but $7.3 million in state and federal funds were restored in conference Tuesday night. Giesting said the amount will cover Medicaid services for those Pacific islanders for only about six months.
Migrants often suffer communicable and chronic diseases, and inadequate health coverage will cause a crisis in already strapped community health centers and hospitals, Giesting said.
"Any time these people don't get covered, we're going to take care of them anyway," said Richard Meiers, president and chief executive officer of the Healthcare Association of Hawaii.
If sick people do not have access to health care through public insurance and community health centers, he said, "then we'll all pay a lot more for care in hospital settings."
The state Department of Health's budget contains $2.1 million in general funds for the 11 community health centers. It also received $1.3 million from the Legislature in rainy day money for the uninsured this fiscal year.
The Health Department requested an additional $2.7 million for the next fiscal year to maintain and expand services to the uninsured.
The Senate, citing state fiscal constraints, deleted the requested increase in general funds and again allocated $1.45 million from the rainy day fund for the health centers.
Gov. Linda Lingle said she added money to the budget for the community health centers after touring them statewide. "My observation is this is a great bang for the buck in the public health care field, for the uninsured and the insured," she said.
Support for Medicaid coverage for Pacific islanders also is critical, she said, pointing out that "the more we spend there, the less we spend in (more expensive) emergency rooms."
Senate Health Chairwoman Rosalyn Baker (D, Honokohau-Makena) and Senate Human Services Chairwoman Suzanne Chun Oakland (D, Kalihi-Liliha) said they will work with their colleagues to try to restore the money as they go into conference.
"I hope at the conference table we will be able to fully fund the uninsured with a preference of having (budgeted) state funds cover this population," Chun Oakland said.
Baker said they would like to get all community health center funding in the Health Department budget so the centers do not have to scramble every year for support.
May Akamine, Kalihi-Palama Health Center executive director, said about 70 percent of its 15,000 patients last year were uninsured and that they made 75,000 visits.
She said the health center had a 6 percent increase in clients last year and that it will run out of state money by the end of this month.
She said the center will have to look "for other donors or types of fund developments and campaigns that we've never done in the past" to cover expenses.