SR66.DOC

WHEREAS, in 1994, Hawaii implemented QUEST, a statewide section 1115 Medicaid waiver program, which offers expanded access and benefits to children and non-disabled adults with incomes below three hundred per cent of the federal poverty level; and

WHEREAS, in 1996, the State made several significant changes that restricted enrollment in the QUEST program and implemented an enrollment cap of one hundred twenty-five thousand people for all QUEST programs; and

WHEREAS, in 1996, the State also reinstated the Medicaid resource test in a new safety net program called QUEST-Net, which serves those who became ineligible for QUEST due to the asset limit; and

WHEREAS, the State required self-employed QUEST enrollees and their spouses to pay a monthly premium, and QUEST-Net enrollees with household incomes above one hundred per cent of the federal poverty level and who are nineteen years of age or older to pay the full QUEST-Net monthly premium; and

WHEREAS, in 1998, the State lowered the eligibility level for QUEST to one hundred per cent of the federal poverty level, with the exception of pregnant women and children, and expanded QUEST-Net to include all individuals who lost eligibility for Medicaid or for QUEST; and

WHEREAS, the QUEST-Net program only covers approximately two hundred twenty adults with incomes between two hundred and three hundred per cent of the federal poverty level, only a portion of adults with incomes at this level; and

WHEREAS, as of February 1, 2008, the federal poverty level for the QUEST-Net adult population was changed from three hundred per cent to two hundred percent; and

WHEREAS, while Hawaii was scaling back eligibility levels, other states were exploring ways to provide health insurance to those uninsured whose incomes are too high to qualify them for public programs, and who do not have access to or cannot afford private insurance; for example, the State of New Jersey raised its State Children's Health Insurance Program eligibility requirement to three hundred fifty per cent of the federal poverty level; and

WHEREAS, in Hawaii, it is believed that families earning over three hundred per cent of the federal poverty level are more likely to have access to employer sponsored health insurance, and since it is not the intent of QUEST to replace health coverage currently provided by employers for dependents, a three hundred per cent federal poverty level ceiling seems reasonable; and

WHEREAS, since the inflation of health care costs, which are growing at a faster rate than incomes, put families with children at severe risk for foregoing medical care, it is time for Hawaii to plan, execute, and maintain health insurance expansions, as well as to improve the availability and affordability of health care coverage; now, therefore,

BE IT RESOLVED by the Senate of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2012, that the Department of Human Services is requested to expand the income eligibility requirement for the State's section 1115 waiver program, as the waiver was granted to Hawaii in 1994 to raise medicaid eligibility to three hundred percent of the federal poverty level; and

BE IT FURTHER RESOLVED that the Department of Human Services is requested to report back its progress on the expansion of the section 1115 waiver program to the Legislature no later than twenty days prior to the convening of the 2013 Regular Session; and

BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Governor, the Director of Human Services, and the Hawaii Health Authority.

	OFFERED BY:	_____________________________

Report Title:

Department of Human Services; QUEST, Medicaid Eligibility; Section 1115 Waiver

THE SENATE	S.R. NO.	66
TWENTY-SIXTH LEGISLATURE, 2012
STATE OF HAWAII