HB1896 HD1

SECTION 1. The legislature finds that Hawaii is consistently ranked among the top states for overall health, including metrics that track the rate of uninsured individuals. According to both U.S. News and WalletHub's annual state rankings for 2017, Hawaii ranked first in the nation in overall health. According to United Health Foundation's annual state rankings for 2017, Hawaii was ranked second in overall health. According to the federal Census Bureau's "Health Insurance Coverage in the United States: 2016" report, Hawaii had the second lowest percentage of uninsured persons in 2016 with only 3.5 per cent of the Hawaii population being uninsured.

The legislature further finds that these excellent rankings are most attributable to Hawaii's Prepaid Health Care Act of 1974. The Prepaid Health Care Act was drafted per the recommendations of a 1971 Legislative Reference Bureau report, authored by Professor Stefan A. Reisenfeld, that estimated Hawaii's health care coverage gap to range from eleven per cent to nineteen per cent, depending on the type of insurance and population estimate. Based on Professor Reisenfeld's recommendations, Hawaii's Prepaid Health Care Act requires that:

(1) Every regular employee in private employment shall have access to a prepaid plan providing for hospital, surgical, and medical benefits;

(2) The level of benefits provided conform with the prevailing community standards;

(3) Costs are shared by the employer and the employee;

(4) The system does not interfere with the collective bargaining process or interfere with the services provided pursuant to such collective bargaining agreements; and

(5) The mandate that employers provide coverage is coupled with a plan for premium supplementation from general revenues.

Enacted after years of negotiation, the Prepaid Health Care Act made Hawaii the first state to have an employer mandate, which requires certain employers to provide health insurance to qualified employees. As stated at the time of the Act's passage in floor debate in the house of representatives, the Prepaid Health Care Act embodies the concept that "every resident of this State has the right to good health and good health care."

Additionally, the legislature finds that the State's creation of MED-QUEST, under its 1115 waiver, supplemented the Prepaid Health Care Act's ambition of providing access to health care to all individuals in Hawaii. Due to its expansion under the Federal Affordable Care Act, more than three hundred thousand persons have access to medical benefits through MED-QUEST.

However, the legislature further finds that the looming uncertainty in the public and private health insurance markets due to instability in federal programs and the Federal Affordable Care Act necessitates that Hawaii continue to innovate and be a pioneer in health care access.

The purpose of this Act is to establish a health care access task force that will review relevant health care policies, legislation, and authority, and make recommendations to improve access to health care in Hawaii.

SECTION 2. (a) There is established a health care access task force within the department of health for administrative purposes. The health care access task force shall review health care policies, legislation, and authority including but not limited to:

(1) Nevada's Assembly Bill 374 (2017), informally known as "SprinkleCare", which proposed the establishment of a Nevada Care Plan to allow any state resident to purchase insurance coverage through that state's Medicaid program on the open market;

(2) Hawaii's Prepaid Health Care Act of 1974;

(3) United States' Senate Bill 1804 (2017), the "Medicare for All Act of 2017";

(4) The Affordable Care Act; and

(5) Chapter 322H, Hawaii Revised Statutes, which established the Hawaii health authority.

(b) The health care access task force shall consist of the following members or their designees:

(1) The director of health, who shall serve as chairperson;

(2) The director of human services;

(3) The director of the executive office on aging;

(4) Two members of the house of representatives appointed by the speaker of the house of representatives;

(5) Two members of the senate appointed by the president of the senate;

(6) The chief executive officer of Healthcare Association of Hawaii;

(7) The director of the Institute for Human Services;

(8) One advocate for health care appointed by the speaker of the house of representatives; and

(9) One advocate for health care appointed by the president of the senate.

The members of the health care access task force shall serve without compensation, and all necessary expenses, including travel expenses, shall be paid by the agency, organization, or department to which the member belongs. No member shall be made subject to chapter 84, Hawaii Revised Statutes, solely because of that member's participation as a member of the task force.

(c) The health care access task force shall submit a report of its findings and recommendations to improve access to health care, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2019.

(d) The health care access task force shall cease to exist on January 10, 2019.

SECTION 3. This Act shall take effect on July 1, 3000.

HOUSE OF REPRESENTATIVES	H.B. NO.	1896
TWENTY-NINTH LEGISLATURE, 2018		H.D. 1
STATE OF HAWAII