Gov. Linda Lingle's concern that the new federal health care reform law may have resulted in the termination of Hawaii's state health care act should be taken seriously. Swift state legislation may be needed to assure continuity—or restoration—of Hawaii's employer-based health care mandate.

Lingle told the Star-Bulletin's Richard Borreca on the PBS “;Insight”; program last Thursday that she has been meeting with the state insurance commissioner, attorney general, health director and others about the effect of the federal health care law on Hawaii.

“;There is a state law that says once there is national health care, that the (Hawaii) Prepaid Health Care Act will no longer exist,”; she said, “;and we are trying to look into that situation right now. ... We're trying to make that determination now.”;

The clause requiring the state law's termination upon the president's signing into law mandated federal health care was included in the state law to satisfy opponents of the legislation, which was enacted in 1974, according to Dr. Lawrence Miike, the state health director in the Cayetano administration.

In a 1993 report to Congress on the experience of Hawaii's health insurance, Miike wrote that the Health Insurance of America, the Hawaii Medical Association and an employers group opposed the legislation because most Hawaii residents already were covered “;and passage of a National Health Insurance Program seemed imminent. To resolve this last concern, the final draft bill contained a clause that would terminate the state program when the federal law passed.”;

President Richard Nixon's proposed comprehensive health insurance proposal died in the midst of Watergate.

The clause remained, stating that the state health care law “;shall terminate ... upon the effective date of federal legislation that provides for mandatory prepaid health care for the people of Hawaii.”;

The new federal law allows Hawaii requirements to prevail in areas where the state law, presumably still in existence, is stronger. For example, the state requirement that all employers offer health insurance to employees would not be affected by the federal law's exemption for businesses with fewer than 50 employees.

The problem, however, is that the termination clause in Hawaii's Prepaid Health Care law may have been triggered by the mere enactment of the federal health reform. If so, state lawmakers, now in session, should be prepared to act quickly to remedy the situation.