THE SENATE	S.C.R. NO.	201
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

SUPPORTING THE REACTIVATION OF THE HAWAII HEALTH AUTHORITY WITH STATUTORY MANDATES THAT SPECIFICALLY INCLUDE THE TRANSITION OF THE STATE'S HEALTH INSURANCE PAYMENT SYSTEM INTO a single-payer health care system.

WHEREAS, the Trump administration and the Republican majority in the United States Congress are threatening deep cuts to federal Medicaid funding; and

WHEREAS, the State may soon be in urgent need for a much more cost-effective health care financing system if cuts to Medicaid funding are implemented; and

WHEREAS, a single-payer health care financing system in the State could achieve large savings from reduced administrative costs without cuts to care delivery by doctors and hospitals; and

WHEREAS, hospitals that are paid with global budgets based on the cost of operations, including salaries for employed doctors, could nearly eliminate the cost of billing and collections that now consume around fifteen percent of total hospital budgets nationwide; and

WHEREAS, independent doctors paid pursuant to a simplified, standardized fee-for-service structure based on time and required training for a given procedure, instead of trying to assign a relative value to each of thousands of procedure codes, could markedly reduce billing and collections costs that now consume around fifteen percent of physician practice revenue nationwide; and

WHEREAS, similar savings in the fifteen percent range could be achieved from reduced administrative cost through the establishment of a single-payer administrator in the State; and

WHEREAS, some of these administrative cost savings could be used to fund community-based programs for high-risk and special needs patients and specialist consultations for primary care to save costs from preventable emergency room visits and hospitalizations; and

WHEREAS, some of these administrative cost savings could be used to improve take-home pay for primary care specialists and psychiatrists so that doctors in under-paid specialties could afford the State's high cost of living, potentially reversing the State's severe physician shortage; and

WHEREAS, health care costs for Medicaid and state and county employee and retiree benefits now consume around thirty percent of the total state budget; and

WHEREAS, the total administrative cost savings from the use of a single-payer administrator could add up to a reduction in the State's health care costs in the range of thirty percent or more, reducing the total state budget by around nine percent; and

WHEREAS, Act 11, Special Session Laws of Hawaii 2009, established the Hawaii Health Authority (HHA), codified at chapter 322H, Hawaii Revised Statutes, with a mission to develop a comprehensive plan for a universal health care system covering all residents of the State, but the HHA is currently inactive; now, therefore,

BE IT RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2025, the House of Representatives concurring, that this body supports the reactivation of the Hawaii Health Authority with statutory mandates that specifically include the transition of the State's health insurance payment system into a single-payer health care system, to be implemented after waivers for Medicare, Medicaid, and Tricare have been obtained and all sources of federal funding for these programs have been exhausted; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Health, Director of Budget and Finance, and Insurance Commissioner.

OFFERED BY:

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Report Title:

Hawaii Health Authority; Single-payer Health Care System; Legislature; Waivers; Medicaid; Medicare; Tricare