Report Title:

Uninsured Health Care



Appropriates funds to provide care for uninsured Hawaii residents.



H.B. NO.














relating to health.





     SECTION 1.  The legislature finds that about ten percent of the population of the State of Hawaii has no public or private health insurance.  According to the Kaiser Commission on Medicaid and the Uninsured:

     (1)  Over four out of five uninsured people are in working families;

     (2)  Uninsured people are more likely than those with insurance to be hospitalized for conditions that could have been avoided;

     (3)  Because the uninsured are less likely to seek preventive care, those with various forms of cancer are more likely to be diagnosed in later stages of the disease resulting in higher rates of death and disability; and

     (4)  Nearly 40 per cent of uninsured adults skipped a recommended medical test or treatment, and 20 per cent say they needed but did not get care for a serious problem in the past year.

     The significant numbers of uninsured residents have a considerable economic impact on the State’s hospitals, community health centers, and other health care providers, threatening their ability to effectively serve the whole community.

     The legislature finds that it is in the best interests of the State to ensure access to primary and preventive health care for its residents.  In addition to facilitating a healthier population, improving access to care reduces state expenditures attributable to hospital and emergency room services for preventable injuries or illnesses.

     The legislature finds that the most effective means to encourage access to primary health care for residents without health insurance is through Hawaii’s system of federally qualified health centers.  These centers: 

     (1)  Are nonprofit, community-based organizations whose purpose and expertise lie in serving people who otherwise have limited or no access to health care; 

     (2)  Provide culturally and linguistically appropriate health care and a broad range of primary care and preventive services, and are located in medically-underserved areas where people have limited access to other health care providers because of geographic and socio-economic barriers;

     (3)  Contribute greatly to the economies and livability of the communities they serve; and

     (4)  Are cost-effective providers whose care results in healthier patients and decreased use of emergency, specialty, and in-patient services.

     Unfortunately, while federally qualified health centers represent one of the most effective and responsive systems of community-based primary care for uninsured people, financial support for these providers is inadequate to meet needs for medical, behavioral health, and dental services. 

     The purpose of this Act is to provide cost-effective care for Hawaii residents who are uninsured while at the same time ensuring that the community health center system remains financially viable and stable in the face of a growing population of uninsured persons.

     SECTION 2.  The department of health shall provide resources to nonprofit, community-based health-care providers for the provision of health care for uninsured persons.

     SECTION 3.  There is appropriated out of the general fund of the State of Hawaii the sum of $2,000,000 or so much thereof as may be necessary for fiscal year 2008-2009 to pay for the provision of direct health care to the uninsured, which may include primary medical, dental, and behavioral health care; provided that distribution of funds may be on a “per visit” basis, taking into consideration need on all islands.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2008.