Report Title:

Health Care for the Uninsured



Appropriates funds to provide health care for uninsured Hawaii residents through non-profit community-based health care providers.



H.B. NO.














relating to health.





     SECTION 1.  The legislature finds that about ten per cent of the adult population of Hawaii have no public or private health insurance.  In the current economic climate of the state, this number is likely to increase with work layoffs and business closures.  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 regular and preventative care, those with various forms of cancer or with chronic conditions are more likely to be diagnosed in later stages of their diseases resulting in higher rates of death and disability; and

(4)  Nearly forty per cent of uninsured adults neglected to get a recommended medical test or treatment, and twenty per cent did not get care for a serious problem requiring treatment in the past year.

     The significant number of uninsured residents has a considerable economic impact on the state's hospitals, community health centers, and other health care providers, threatening the effectiveness of these providers to serve the whole community.

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

     The legislature further 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, which:

(1)  Are non-profit, 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 preventative services;

(3)  Are located in medically-underserved areas where people have limited access to other health care providers because of geographic and socio-economic barriers;

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

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

     A recent study indicated that community health centers saved Hawaii an estimated $29 million in 2007 in their services to the uninsured.  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 the community's needs for medical, behavioral health, and dental services.

     The purpose of this Act is to appropriate funds to provide cost-effective care for uninsured Hawaii residents and ensure that the community health center system remains financially viable and stable as the number of uninsured persons grows.

     SECTION 2.  There is appropriated out of the general revenues of the State of Hawaii the sum of $         or so much thereof as may be necessary for fiscal year 2009-2010 for the provision of direct health care services to uninsured residents, including medical, dental, and behavioral health care through non-profit, community-based health care providers; provided that the distribution of funds may be on a "per visit" basis, considering the needs on all of the islands.

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

     SECTION 3.  This Act shall take effect on July 1, 2009.