Creates a three-year pilot program in which DHS pays half of the premiums for the health care provided by a mutual benefit society to uninsured children thirty-one days to eighteen years old who are ineligible for other state or federal health care coverage. Appropriates funds. Sunsets June 30, 2009. (SD1)

A BILL FOR AN ACT

SECTION 1. Although estimates of the rate of uninsured children in the State vary, one thing that can be agreed upon is that there is a gap group that is ineligible for any state or federal health care coverage. Children who remain uninsured typically do not receive an appropriate level of medical care. Children who lack a source of care or must turn regularly to a hospital emergency department are unlikely to receive preventive care or early and regular management of acute or chronic health conditions.

A study performed by the Urban Institute, a nonpartisan economic and social policy research organization, showed that regardless of age, race, ethnicity, income, or health status, uninsured children were much less likely to have received a well-child checkup within the past year and were more likely than insured children to report an unmet need for medical care that was associated with concerns about cost.

Health insurance helps children and youth receive regular health care so they can participate in school and other activities. Often, parents experience hardship when an uninsured child is sick because of the added stress of the child's medical bills.

Local health care coverage providers offer children's plans that cover certain preventive services, immunizations, doctor visits, diagnostic tests, emergency care, mental health benefits, and some prescription drugs.

The State has the opportunity to help provide health care coverage for children in the gap group through partnerships with mutual benefit societies such as the Hawaii Medical Service Association. Such partnerships will allow the State to offer coverage to uninsured children under the existing children's plans offered by these mutual benefit societies. The cost of the premium will be split equally between the partner mutual benefit society and the State.

The purpose of this Act is to establish the Hawaii children's health care program, as a temporary three-year pilot program to provide health care coverage to uninsured children.

SECTION 2. Hawaii children's health care program; three-year pilot program; establishment. (a) There is established the Hawaii children's health care program as a temporary three-year pilot program to provide health care coverage to uninsured children. The pilot program shall provide health care coverage through a public-private partnership, established as a purchase of service pursuant to chapter 103F, Hawaii Revised Statutes, between the department of human services and a mutual benefit society operating in the State under chapter 432, Hawaii Revised Statutes, that offers accident and health or sickness insurance plans.

(b) To qualify for this program, a child shall:

(c) The department of human services and the mutual benefit society shall share equally in the cost of the premium for each child enrolled in the pilot program.

(d) The department of human services shall pay the State's share of the premiums under the pilot program on a quarterly basis.

(e) The mutual benefit society participating in the pilot program shall be responsible for determining eligibility for children's health care program applicants and for enrollment in the program.

(f) The mutual benefit society participating in the pilot program shall provide a quarterly report to the department of human services and the legislature on the number of children enrolled in the children's health care program.

(g) Other private organizations may partner with the State to offer coverage to uninsured children under the Hawaii children's health care program; provided that the plan benefits to be provided shall be equal to or better than those offered by the pilot program established by the State and a mutual benefit society under subsection (a).

(h) All children currently enrolled in a mutual benefit society's children's plan shall be eligible for enrollment into the Hawaii children's health care program.

(i) The Hawaii children's health care program shall terminate on June 30, 2009.

SECTION 3. 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 2006-2007, for the Hawaii children's health care program pursuant to this Act.

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

SECTION 4. This Act shall take effect on July 1, 2006, and shall be repealed on June 30, 2009.