Honorable Robert Bunda

President of the Senate

Twenty-First State Legislature

Regular Session of 2002

State of Hawaii

Sir:

Your Committee on Health and Human Services, to which was referred S.B. No. 2140 entitled:

begs leave to report as follows:

The purpose of this measure is to provide presumptive eligibility Medicaid or QUEST coverage to pregnant women for prenatal care and other medically indicated services.

Testimony in favor of this measure was submitted by the Hawaii Commission on the Status of Women, Hawai'i Primary Care Association, Hawai'i Nurses' Association, Hawaii Island Rural Health Association, Inc., Blueprint for Change, Ka'u Rural Health Community Association, Inc., March of Dimes, Healthy Mothers, Healthy Babies, Waianae Coast Comprehensive Health Center, Mothers Care for Tomorrow's Children, Maui Family Support Services, Inc., Kahuku Hospital, Kokua Kalihi Valley, and three private citizens. Testimony in opposition to this measure was submitted by the Department of Human Services (DHS).

This measure would require the DHS to provide presumptive Medicaid or QUEST coverage to pregnant women for prenatal and other medically indicated services, if applicants show proof of pregnancy and meet income qualifications. This measure also provides that infants of women presumptively covered under QUEST are deemed eligible for medical services, and would be processed for the State Children's Health Insurance Program (SCHIP).

Prior to the DHS's QUEST program in 1994, pregnant women were presumed eligible for prenatal care under Medicaid. However, that presumption was not carried over to the QUEST program, with the consequence that pregnant women had to undergo a lengthy application process to qualify under QUEST. Although the DHS has made good faith efforts to address the delays, the current wait time averages four to six weeks. The legislature finds that this period of delay is unacceptable.

Early and continuous prenatal care for pregnant women is the primary cost-effective method for preventing low birthweight and poor birth outcomes. Low birthweight has been determined to be one of the top three most expensive reasons for hospital stays.

As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 2140 and recommends that it pass Second Reading and be referred to the Committee on Ways and Means.