Hawaii May Get to Opt Out of Health Bill
Hawaii would be allowed to opt out of key requirements of national health care reform legislation, the only state given such a privilege because it already has its own comprehensive health insurance law.
Hawaii's exemption is written into three paragraphs of the 1,900-page House bill that's set for a vote Saturday.
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U.S. Rep. Mazie Hirono, D-Hawaii, said Thursday that Hawaii's 35-year-old health law should be preserved because its requirement that employers pay for full-time workers' health insurance has boosted the number of insured residents to one of the highest rates in the nation.
"We have this exemption because our prepaid health care law is better than whatever the federal government provides," said Hirono, who introduced the Hawaii amendment to the bill. "Hawaii has a very progressive law on its books, which no other state has tried."
A similar employer requirement in the federal legislation would make workers pay more, Hirono said.
Employers would pay 72.5 percent of premium costs under the House bill, compared to 98.5 percent under Hawaii law.
About 8 percent of Hawaii residents are uninsured, second only to 5 percent in Massachusetts, according to the Kaiser Foundation, a nonprofit research organization focusing on U.S. health care. The national average is 15 percent.
"Hawaii is ahead of the curve in health care in that we've already implemented many of the reforms that they're just talking about now in the federal health care legislation," said Jennifer Diesman, a spokeswoman for Hawaii Medical Service Association, the state's largest health insurer. "It works, and it really does promote access to health care at every level."
Besides the requirement that employers pay for health coverage, Hawaii's law also sets a minimum level of benefits and mandates that workers with pre-existing conditions not be denied coverage.
No other state would be allowed to opt out of federal health overhaul legislation, a provision sought by some senators. A similar exemption for Hawaii is included in the Senate version of the bill.
"Any kind of opt-out provision for the other states should be contingent on these other states coming up with an insurance plan that meets or exceeds federal standards," Hirono said. "They shouldn't be able to opt out just because they feel like it."
The parts of the national health reform bill that apply to uninsured Hawaii residents would remain in effect, Hirono said.
Those include provisions for subsidies to those who can't afford coverage and a closing of the prescription drug coverage gap known as the "doughnut hole," where Medicare beneficiaries start paying the full cost of their drugs until they qualify for catastrophic coverage.
It would be up to Hawaii's Legislature to decide whether it wants the state to participate, Hirono said.