S.C.R. NO.














requesting the auditor to conduct a social and financial assessment of proposed mandatory health insurance coverage for services provided by pharmacists.



     WHEREAS, there is a shortage of physicians throughout the State; and


     WHEREAS, all four counties in the State include areas designated as "medically underserved"; and


     WHEREAS, pharmacists could help to bridge the gap in providing access to basic health care; and


     WHEREAS, pharmacists graduate with a doctor of pharmacy that requires a minimum of six years to complete, and may complete two years of post-graduation residency training programs alongside their physician colleagues or become nationally board certified in numerous specialties; and


     WHEREAS, a pharmacist's skill set includes educating patients on how and when to check blood sugar, ways to avoid and manage hypoglycemia, how to take their medications correctly to avoid adverse effects, and various medication utilization techniques; and


     WHEREAS, patients are three times more likely to stay out of the hospital when pharmacists provide clinical services after a hospital discharge; and


     WHEREAS, Senate Bill No.      , introduced in the Regular Session of 2023, proposes to expand existing health insurance coverage to cover medical services provided by pharmacists within their scope of practice; and


     WHEREAS, section 23-51, Hawaii Revised Statutes, requires that "[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage"; and


     WHEREAS, section 23-51, Hawaii Revised Statutes, further provides that "[t]he concurrent resolutions shall designate a specific legislative bill that:


     (1)  Has been introduced in the legislature; and


     (2)  Includes, at a minimum, information identifying the:


          (A)  Specific health service, disease, or provider that would be covered;


          (B)  Extent of the coverage;


          (C)  Target groups that would be covered;


          (D)  Limitations on utilization, if any; and


          (E)  Standards of care.


For purposes of this part, mandated health insurance coverage shall not include mandated optionals."; and


     WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the Auditor's report; now, therefore,


     BE IT RESOLVED by the Senate of the Thirty-second Legislature of the State of Hawaii, Regular Session of 2023, the House of Representatives concurring, that the Auditor is requested to conduct an impact assessment report in accordance with sections 23-51 and 23-52, Hawaii Revised Statutes, of mandating health insurance coverage for services provided by pharmacists within their scope of practice as proposed in Senate Bill No.      , introduced in the Regular Session of 2023; and


     BE IT FURTHER RESOLVED that the Auditor is further requested to include in its assessment the impact of section 1311(d)(3) of the federal Patient Protection and Affordable Care Act (PPACA) on Senate Bill No.      , Regular Session of 2023, or similar legislation, that includes but is not limited to the additional cost of any benefits beyond the essential health benefits of Hawaii's qualified health plans under the PPACA; and


     BE IT FURTHER RESOLVED that the Auditor is also requested to determine how many qualified health plans are available in Hawaii, including plans offered by health maintenance organizations; the individual or group enrollment in these plans; and the actuarial cost of the defrayment to the State for the reimbursement of services provided by pharmacists; and


     BE IT FURTHER RESOLVED that the Auditor is requested to submit a report on its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2024; and


     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and Insurance Commissioner, who is requested to transmit copies to each insurer in the State that issues health insurance policies.
















Report Title: 

Auditor; Impact Assessment Report; Mandatory Health Insurance Coverage; Pharmacists