The biggest winners in Hawaii from federal health care reform are likely senior citizens and hospitals that serve a large share of low-income people, according to supporters.

But a local Republican official predicted that island families will feel the impact with skyrocketing medical insurance premiums.

The bill approved by the U.S. Senate yesterday would strengthen Medicare, closing a coverage gap that leaves one-third of local seniors paying full price for prescription drugs, said a spokesman for AARP.

“;The bill passed by the Senate makes needed progress to prevent coverage denials due to health status and limit insurance companies from charging older Americans much more for coverage because of their age,”; said A. Barry Rand, AARP national chief executive officer, in a statement. In 2008 there were more than 193,000 Medicare beneficiaries in Hawaii who typically spend 30 percent of their income on health care, according to AARP data.

The bill includes an amendment by U.S. Sen. Daniel Akaka that would permanently restore a Medicaid Disproportionate Share Hospital allotment that will “;provide additional funding to the state of Hawaii to permit a greater contribution toward the uncompensated care costs of hospitals that treat the uninsured and Medicaid beneficiaries,”; Akaka said in a statement. Hawaii, one of two states not permanently enrolled in the program, would receive more than $100 million for the local health care industry over the next 10 years.

Hawaii hospitals lost $114 million on Medicare services and $78 million on Medicaid/Quest service to low-income and uninsured people, according to a November report to the Healthcare Association of Hawaii.

State Republican Party Chairman Jonah Ka'auwai said the legislation is “;loaded with more government, tax increases and higher health care costs,”; adding, “;The Centers for Medicare and Medicaid Services estimate families with private insurance will see their premiums increase by as much as $2,100 a year because of the bill.”;

In a written statement, Ka'auwai said the plan proposed by House Republicans would have reduced premiums by as much as 10 percent. “;Instead of voting for these common-sense and cost-reducing measures, Democrats rammed this government-run health care program through Congress when Americans don't want it and our country can't afford it.”;

The Senate passed the bill in a 60-39 vote, strictly along party lines.

In general, Hawaii is ahead of most states in coverage of workers and uninsured people, and the bill would not roll back programs in place here.

“;This bill ensures that Hawaii ... maintains its high level of health care while expanding the reach of existing federal programs,”; said U.S. Sen. Daniel Inouye.

A 1975 state law ensures health insurance for every employee working at least 20 hours a week.

Hawaii Democratic Party Chairman Brian Schatz said Senate approval of the Patient Protection and Affordable Care Act “;was the single most important vote on domestic policy in decades and marks real progress towards health care for all Americans.”;