THE SENATE

S.B. NO.

2783

THIRTY-SECOND LEGISLATURE, 2024

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to MEDICAID.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that access to high quality health care that is accessible, affordable, and equitable is of paramount importance to public health and wellness.  The legislature finds however, that presently, approximately five hundred pregnant persons and four thousand income-qualified children in the state are denied access to affordable health care through medicaid, the children's health insurance program, and health insurance exchanges established under the Patient Protection and Affordable Care Act, P.L. 111-148, solely due to their immigration status.  Furthermore, evidence-based studies determined that low-income immigrants without prenatal care are seven times more likely to give birth prematurely and five times more likely to experience neonatal death, demonstrating that limited access to health care for pregnant persons and their newborn children significantly increases risk of exposure to life-threatening situations. 

     As of September 2023, twenty states provide medicaid coverage to all income-qualified pregnant residents regardless of their immigrant status.  For Hawaii, with the current cost of an average neonatal intensive care unit stay being between $7,000 and $8,000 per day, the department of human services estimates the cost of providing income-qualified pregnant persons with health insurance coverage and twelve months of post-partum care at $1,364,000 annually.  Providing greater access to health insurance coverage for income-qualified pregnant persons will help lower barriers and increase access to health care for resident immigrant populations in the State.

     Similarly, low-income immigrant children without access to health care services experience a higher rate of preventable hospitalizations during childhood.  Without appropriate medical management, chronic conditions such as asthma and diabetes may lead to life-threatening medical emergencies.  Additionally, inadequate access to preventative care such as immunizations and well-being and well-child visits may aggravate various health conditions increasing the occurrence of acute and chronic conditions, and can leave developmental health conditions undiagnosed and untreated. 

     As of September 2023, twelve states and the District of Columbia provide medicaid coverage to income-eligible children regardless of immigration status.  As for Hawaii, the department of human services estimates the cost of providing income-qualified children with health insurance coverage under the federal health services initiative program at $2,976,000, with a wholly funded state program estimated at $9,600,000.  Increasing access to health insurance coverage for income-qualified children will improve health care outcomes for all keiki, regardless of immigration status.

     Therefore, the purpose of this Act is to appropriate funds to the department of human services to authorize medicaid coverage to income-qualified pregnant persons and children regardless of immigration status.

     SECTION 2.  In accordance with section 9 of article VII of the Hawaii State Constitution and sections 37-91 and 37-93, Hawaii Revised Statutes, the legislature has determined that the appropriations contained in Act 164, Regular Session of 2023, and this Act will cause the state general fund expenditure ceiling for fiscal year 2024-2025 to be exceeded by $           or       per cent.  This current declaration takes into account general fund appropriations authorized for fiscal year 2024-2025 in Act 164, Regular Session of 2023, and this Act only.  The reasons for exceeding the general fund expenditure ceiling are that:

     (1)  The appropriation made in this Act is necessary to serve the public interest; and

     (2)  The appropriation made in this Act meets the needs addressed by this Act.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $1,364,000 or so much thereof as may be necessary for fiscal year 2024-2025 to provide medicaid coverage through the children's health insurance program for income-qualified pregnant persons who are otherwise ineligible due to their immigration status.

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

     SECTION 4.  There is appropriated out of the general revenues of the State of Hawaii the sum of $2,976,000 or so much thereof as may be necessary for fiscal year 2024-2025 to provide medicaid coverage through the children's health insurance program for income-qualified children who are otherwise ineligible due to their immigration status.

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

     SECTION 5.  This Act shall take effect on July 1, 2024.

 

INTRODUCED BY:

_____________________________

 

 

 

 

 

Report Title:

DHS; Medicaid Coverage; Pregnant Persons; Children; Immigration Status; Expenditure Ceiling; Appropriations

 

Description:

Appropriates funds to the Department of Human Services for Medicaid coverage under the Children's Health Insurance Program for income-qualified pregnant persons and children, regardless of immigration status.  Declares that the general fund expenditure ceiling is exceeded.

 

 

 

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