Hi,
The Hawaii Health Authority has a new bill and more support at the capitol. Now it needs our phone calls and emails to get funded this session.
Right now, we can thank the introducers and call the first committee members to ask them to support the Hawaii Health Authority.
Thank you Representative John Mizuno for leading the effort to revive the Hawaii Health Authority with HB2503, and thank you to CACHOLA, ICHIYAMA, C. LEE, LOWEN, MCKELVEY, WILDBERGER, Brower, Creagan, DeCoite, San Buenaventura in the House. In the Senate, thank you KOUCHI (Introduced by request of another party) for companion bill SB3127
Will we soon be thanking Governor Ige for his support? In 2009, Senator David Ige did vote for the Hawaii Health Authority; where’d that guy go? Into HMSA’s...., let’s say, point of view. Let’s help Gov Ige to see the light; simpler insurance costs much less than complex insurance. He's not taking calls on the topic; call often anyway.
Contrary to the mantra of many of our state officials, who all uniformly maintain, “there is very little if any savings to be had from administrative simplification,” in fact, less time spent on processing insurance costs less than spending more time processing insurance. Somehow, that is a hard concept for friends of Managed Care (2009 to the present) to understand.
Fixing healthcare is simple. Understanding our current massive insurance bureaucracy is wildly complex, and that is why it must be thrown away. Private health insurance - in the USA only - cannot be reformed. It must be thrown out.
The HHA can, if allowed, design a plan and then submit that plan to the legislature for review, rejection, or, approval. Step one, if funded, is just to take three to six months to draft up a plan, and then submit that plan to the lege for consideration. If the lege approves it, hey presto, our insurance premiums will likely go down 30%, coverage will be 100%, and co pay/out of pocket will go significantly down. Workers compensation rates could go down 70%, because all employees will see zero barriers to getting covered. To eliminate out of pocket expenses, we probably need to push a federal Medicare For All bill through congress, but a state can still make significant improvements, and who knows, after the numbers are crunched, maybe a state universal Unified All Payer System might be able to eliminate most out of pocket expenses. We won’t know until we give the HHA a little budget and time to draft it up.
Here is what it looks like:
All insurance companies in Hawaii, including HMSA, Kaiser, Medicaid providers and Medicare Advantage providers will be given the same business plan by the HHA.
They will offer one comprehensive benefit package, bill for it the same way, and pay doctors for it the same rate. That’s it!!!!!! Add in global budgets for individual hospitals and a few more acronyms for spice, but that’s about it.
That simplicity will knock out up to 80% of current medical biller jobs, on both sides, payer and provider. The former MFA bill H676 provided $20 billion for two years of full pay for all displaced insurance workers. Bernie is talking about covering 5 years of pay. I believe Hawaii could fund our unemployment department to take care of displaced insurance workers. Instead of normal UI benefits, the state could increase those benefits and extend the time for two years, to ensure that no one loses their home, and has time to transition to a new career. They might need to apply for Quest, but, the new application form will just be an application form; it won't have any of the risk adjustment/cost adjustment time wasting bureaucracy. Healthcare Yes! Paperwork No!
Many new jobs will open up, due to increased hiring of PROVIDERS and lowering the cost of business. Our current nurse to patient ratio is too high; we need more nurses and in general we need more healthcare providers in every position.
To those who are deeply concerned about insurance workers losing their jobs, well, I share your support of the government providing ‘make work,’ which is what insurance jobs are. They are bureaucratic jobs that add cost not value to healthcare. The tax payer would be better off paying them to work in the DMV or DoH, or DoE, etc.
More good news, in 2018 the Hawaii Democratic Party passed an ideal ‘single payer’ friendly health platform. This platform adds detail to the general idea described above. Bad news, oops, not too many Democrats in office have read that platform, yet! But you can call their office and read it to their staff over the phone...
Below that is the actual bill.
Before you get too excited and read the whole bill, please note the most important part --- the Call To Action.
Yes, now that we have a bill, we the people must tell our officials, they the guys with the purse, to fund it.
PLEASE call each of the co signers to thank them for supporting the Hawaii Health Authority.
PLEASE call the chair of the first committees and ask them to schedule a hearing. The first hearing in the house will be in the Health Committee, chaired by Rep Mizuno. He is sure to pass it, but, rockets need a large boost of energy at the point of ignition. All of the committee members need to hear our enthusiasm. Call Rep Mizuno to thank him, and call and email everyone on the committee to ask for their support.
Next action item, please compose your top three reasons for supporting the HHA, with each reason being either a phrase or max three sentences, and post that in the comments. Let’s work on our messaging, in order to create more allies across the community. Then print some up, and periodically email those pithy bits to your rep and sen.
One senator recently said, in explaining his opposition to single payer, "no one is knocking on my door demanding radical change, so I'm supporting incremental change via a public option." That was Senator Brian Schatz.
Our representatives are asking us to knock on their doors and tell them how we feel.
For me,
Businesses will save money by no longer paying rip off prices for insurance.
Homelessness can be nearly ended by adopting Lt Gov Josh Green’s 2017 idea to classify homelessness as a medical condition under Medicaid (it costs less to house people than to pay medical bills caused by being homeless)
and everyone will be healthier, with more cash in their own pocket, instead of losing it to health bills.
John M. Mizuno
House District 28
Hawaii State Capitol, Room 402
phone: 808-586-6050
fax: 808-586-6051
repmizuno@Capitol.hawaii.gov
Vice Chair of Health:
Bertrand Kobayashi
House District 19
Hawaii State Capitol, Room 403
phone: 808-586-6310
fax: 808-586-6311
repkobayashi@Capitol.hawaii.gov
Health Committee Members:
Della Au Belatti House District 24
Hawaii State Capitol
Room 439
phone: 808-586-9425
fax: 808-586-9431
repbelatti@Capitol.hawaii.gov
Nadine Nakamura House District 14
Hawaii State Capitol
Room 314
phone: 808-586-8435
fax: 808-586-8437
repnakamura@Capitol.hawaii.gov
Joy SanBuenaventura House District 4
Hawaii State Capitol
Room 442
phone: 808-586-6530
fax: 808-586-6531
Calvin K Y Say House District 20
Hawaii State Capitol
Room 418
phone: 808-586-6900
fax: 808-586-6910
repsay@Capitol.hawaii.gov
Jimmy Tokioka House District 15
Hawaii State Capitol
Room 305
phone: 808-586-6270
fax: 808-586-6271
reptokioka@Capitol.hawaii.gov
For the Senate, SB 3127
Rosalyn H. Baker
Senate District 6
Hawaii State Capitol, Room 230
phone: 808-586-6070
fax: 808-586-6071
senbaker@capitol.hawaii.gov Note: Sen Baker rushed Ige’s 2017 bill to abolish the HHA through her committee, with barely any testimony. She is strongly anti HHA. Do your best to engage her in respectful conversation about why we need it. She may have tried to abolish the HHA, but we need to persuade her to give the HHA a chance in 2020. Repeatedly calling and emailing and showing up in her office is about our only leverage.
Vice Chair
Stanley Chang
Senate District 9
Hawaii State Capitol, Room 226
phone: 808-586-8420
fax: 808-586-8426
senchang@capitol.hawaii.gov Sen Chang has introduced a single payer bill, and has stated support for the HHA in the past.
These are the other members of the Senate Health Committee. Please look their info up and ask them to support the HHA. Rudderman has been a supporter.
Clarence K. Nishihara Glenn Wakai Russell E. Ruderman Kurt Fevella Laura H. Thielen
Health Platform of the Hawaii Democratic Party, 2018 – till next convention.
We believe that healthcare is a right, not a privilege, and our healthcare system must put people before profits. The high costs of insurance and insufficient coverage mean that many people do not have access to the care they need, which creates devastating social costs that are also a significant economic burden to the State.
Therefore, we support robust funding of the Hawai‘i Health Authority (HHA) or other State Health Agency to design a statewide, unified, cost-effective healthcare system that includes comprehensive healthcare services for all, and then submit that design to the legislature for evaluation.
Such a universal, comprehensive healthcare system would:
(1) Unify the delivery of healthcare in Hawai‘i by establishing a single network, benefit structure, reimbursement system, drug formulary, and prior authorization policies; (All state-regulated payers would be required to pay into this unified system, including Medicaid, Medicare Advantage, and health insurance provided by the state and counties, and commercial health insurance plans funded by employers and individuals.);
(2) provide parity of mental and physical health coverage.
(3) provide cost-effective regulation of comprehensive health care delivery systems with an administrative overhead of less than 3%;
(4) include and protect all women’s healthcare needs including 30 reproductive rights and the healthcare needs of the LGBTQIA community.
(5) provide preventative health programs
(6) provide long-term care, dental, and vision care; and
(7) provide healthcare to Compact of Free Association (Federated States of Micronesia, the Marshall Islands, and Palau) (COFA)) citizens and other non-citizens lawfully residing in Hawai‘i on an equal basis with US citizens and permanent residents.
https://hawaiidemocrats.org/wp-content/uploads/2018/10/2018-State-Platform-1-6-13-18.pdf
http://hha.hawaii.gov/
HOUSE OF REPRESENTATIVES
H.B. NO.
2503
THIRTIETH LEGISLATURE, 2020
STATE OF HAWAII
A BILL FOR AN ACT
RELATING TO THE HAWAII HEALTH AUTHORITY.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. (a) The Hawaii health authority was established in 2009 as an autonomous body responsible for the overall health planning for the State and for advising the State on the future capacity needs of the people of Hawaii for health providers, facilities, equipment, and support service providers. However, the legislature finds that the authority has been deprived of resources since late 2014 and needs to be reinvigorated and provided with necessary funding to carry out its duties and responsibilities. This includes developing a comprehensive plan for all individuals in Hawaii.
In developing a comprehensive health plan, the legislature asks the Hawaii health authority to consider including in the comprehensive health plan the use of the all‑payer healthcare model as adopted in the State of Maryland for Hospitals. An
all-payer health care model:
(1) Requires the same price for the same service regardless of the source of funding for a given patient, thereby achieving substantial administrative savings and eliminating a major cause of discrimination against sicker, poorer patients, including those covered by Medicaid;
(2) Establishes a standardized, simplified fee schedule for independent professionals that is negotiated between the State and associations representing health professionals, and applies to all payers doing business in the State of Hawaii;
(3) Pools hospital funding from all payers so as to pay hospitals with global operating budgets, instead of fee-for-service, eliminating most billing and collection costs, cost-shifting due to losses from uncompensated and under-compensated care, and substantially reducing other hospital administrative costs. Incentives for hospitals shall also be eliminated, allowing for resources to be focused on services that are profitable under fee-for-service, at the expense of needed services that are generally not profitable under fee-for-service, including emergency services, psychiatric services, and geriatric care; and
(4) Outlines actions needed for acquiring medicare and medicaid waivers from the federal government to implement an all-payer health payment system.
(b) The legislature further finds that the unfunded liabilities of the Hawaii employer-union health benefits trust fund must be addressed to avoid potentially millions of dollars in unfunded liabilities in later years and can be done so in the comprehensive health plan. A plan and structure that best address the liabilities that are currently unfunded have the following features:
(1) Provide health benefits to state and county employees and retirees using a self-funding model in which the state retains insurance risk, eliminating the need to pre-fund health benefits as required when contracting health benefits through fully insured health plans;
(2) Cap public employer prefunding through the Hawaii employer-union health benefits trust fund and other post-employment benefits trust fund once the separate accounts for each public-employer have a combined balance of at least $2,000,000,000;
(3) Thereafter, transfer any investment income and interest from the Hawaii employer-union health benefits trust fund and other post-employment benefits trust fund to a newly established rate stabilization reserve fund, which will provide reserve funding to stabilize the Hawaii employer-union health benefits trust fund when the trust fund has insufficient moneys to cover the costs of providing health and other benefits plans for active employees and retirees and their beneficiaries; and
(4) Continue to provide for the use of a portion of transient accommodations tax revenues to supplement deficient county public employer contribution amounts if necessary.
(c) Accordingly, the purpose of this Act is to enable the Hawaii health authority to fulfill its duties and responsibilities, which include developing a comprehensive health plan for all individuals in Hawaii, by:
(1) Directing the Hawaii health authority to submit a comprehensive health plan that includes an all-payer model and a funding source for the unfunded liabilities of the Hawaii employer‑union health benefits trust fund; and
(2) Appropriating funds to the Hawaii health authority for the hiring of an executive director and other staff and expenses necessary for the authority.
SECTION 2. Section 322H-1, Hawaii Revised Statutes, is amended to read as follows:
"[[]§322H-1[]] Hawaii health authority; establishment. (a) There is established within the department of budget and finance for administrative purposes the Hawaii health authority. The authority shall be an autonomous public body corporate and politic and an instrumentality of the State.
(b) The authority shall be composed of nine members appointed by the governor as provided in section 26-34; provided that three members shall be appointed from a list of nominees submitted by the speaker of the house of representatives and three members shall be appointed from a list of nominees submitted by the president of the senate[. All]; provided further that beginning July 1, 2020, the governor shall provide for staggered terms. Thereafter, all members shall be appointed for terms of four years each. The majority of the members shall be health care professionals with direct patient care experience. All members must share a commitment to the goal of an integrated universal health care system covering all residents of Hawaii, and the members shall be representative of the diversity of the citizens of the State.
(c) [One member shall be selected to be the executive director and confirmed by a majority vote of a quorum of the members of the Hawaii health authority.] The authority shall hire an executive director who shall be exempt from chapter 76 and such other staff as necessary to assist in the performance of the authority's duties and responsibilities. The staff of the authority shall be hired without regard to chapter 76; provided that the executive director and staff shall be eligible to participate in state employee benefit plans.
(d) Each member shall hold office until the member's successor is appointed and qualified.
(e) Five members shall constitute a quorum, whose affirmative vote shall be necessary for all valid actions by the authority.
(f) The authority may incur expenses as it finds necessary to perform its duties and responsibilities. The authority shall submit an annual report accounting for its spending to the director of finance and to the legislature no later than twenty days prior to the convening of each regular session."
SECTION 3. Section 322H-2, Hawaii Revised Statutes, is amended by amending subsection (e) to read as follows:
"(e) The authority shall submit [a comprehensive health plan for all individuals in the State, including its findings and recommendations, to the legislature no later than twenty days prior to the convening of the regular session of 2012.] an updated comprehensive plan using an all-payer healthcare model and resolving unfunded liabilities of the Hawaii employer-union health benefits trust fund to the legislature no later than twenty days prior to the convening of the regular session of 2021. The authority shall additionally survey matters relating to healthcare in the State of Hawaii, including findings and recommendations regarding such matters, and shall submit annual reports to the legislature no later than twenty days prior to the convening of each regular session."
SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $250,000 or so much thereof as may be necessary for fiscal year 2020-2021 to the Hawaii health authority for the hiring of an executive director and other staff expenses necessary to carry out its duties and responsibilities.
The sum appropriated shall be expended by the Hawaii health authority for the purposes of this Act.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on July 1, 2020.
INTRODUCED BY:
_____________________________
Report Title:
Hawaii Health Authority; Comprehensive Health Plan; Unfunded Liabilities; Appropriation
Description:
Directs HHA to submit to the legislature a comprehensive health plan that includes an all-payer model and a funding source for the unfunded liabilities of the employer-union health benefits trust fund. Amends the requirements for appointment to HHA. Appropriates funds to HHA for the hiring of an executive director and other staff and expenses necessary for the authority.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
Dennis B Miller