Bills seek wider
health coverageQuestions remain about how
to extend medical insurance
to part-time employees
While the state's Prepaid Health Care Act of 1974 guaranteed insurance for those employed full time, rising health care costs and the growing number of uninsured in Hawaii have lawmakers looking once again at ways to cover part-time workers.
A year after a universal-care proposal died in committee, House members are taking up the issue again today.
A bill before the House Labor and Health committees would set up the Hawaii Health Alliance, a government agency that would be responsible for providing health care, either directly or through contracts with insurers, for people not covered by their employers' plans.
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It is one of two House bills addressing Hawaii's uninsured population scheduled to be heard by the committees.
The other would establish a state health authority to study the feasibility of a universal system and determine how such an entity would be formed and financed.
A Senate bill on universal health care has not been scheduled for a hearing.
The Hawaii Health Alliance proposal in the House aims to provide basic health coverage for those not covered by the Prepaid Health Care Act, under which a business must provide coverage for an employee who works 20 hours or more a week for four consecutive weeks, with the employee paying no more than 1.5 percent of his or her salary for his or her share of the premium.
Labor Chairman Marcus Oshiro, who introduced the bill, said he expects the proposal could provide health coverage for up to 58,000 uninsured residents -- about half the state's estimated population of 120,000 uninsured.
"We anticipate greater coverage for these 58,000 lives, which would save us in the long run because currently we pick up their costs when they go the health centers," said Oshiro (D, Wahiawa-Poamoho). "The hospitals pass on their bad debt charges because they service these people but they don't get any reimbursement."
The proposal is patterned after the fledgling universal health care program in Maine that was passed last year. That state's Dirigo Health program is expected to sign its first enrollees this summer.
As Hawaii's proposal would, Maine's public-private partnership plans to contract with private insurers to provide coverage to those who need it. Among the provisions, enrollees who are ineligible for Medicaid will pay for coverage, with premiums based on ability to pay. Coverage will also be available under group policies made available to businesses and municipalities with 50 or fewer employees, and to the self-employed.
"This is just another option for the small businesses and the folks here not covered under Prepaid Health Care," Oshiro said. "What (Rep.) Dennis (Arakaki) is looking at is more of a true universal health care."
Arakaki, the House Health Committee chairman, said his proposal would establish a new state agency charged with bringing together all state-funded health programs to determine how best to serve Hawaii's uninsured population. It also would be tasked with coming up with a funding mechanism for carrying out its mission.
"Basically, we want to have this high-level commission be able to determine what kind of mechanisms we need" to cover more of Hawaii's uninsured, said Arakaki (D, Alewa Heights-Kalihi).
