Hawaii Health Care Essay

Hawaii is home to over 1.4 million people spanning across six major islands. In addition to being an ethnically diverse state, Hawai’i also has a diverse workforce, with tourism, government, and military accounting for major elements of the economy. Conversely, Hawaii has a small and unique insurance marketplace consisting of only four, not-for-profit, health plans- University Health Alliance, Hawai’i Management Alliance Association, Kaiser Permanente, and the Hawai’i Medical Service Association.

Another unique characteristic of Hawaii’s insurance marketplace is the Hawai’i Prepaid Health Care Act which requires employers with at least one permanent, full-time employee to purchase employee health insurance coverage. Hawai’i is the only state

Employers in Hawai’i can offer plans of lesser actuarial value (80%-60%, equivalent to ACA’s “gold” and “bronze” categories, respectively) if they contribute at least half of the cost of the coverage of dependents under those plans. The Prepaid Act is administered and enforced by the State Department of Labor and Industrial Relations (DLIR) while the Department of Commerce and Consumer Affairs’ Insurance Division is responsible for insurance and rate

1301, 1304, 1311, and 1312) that conflicts with the Prepaid Act and disrupts the makeup and sustainability of health coverage for small businesses in the state. As compared to the SHOP, the Prepaid act offers health coverage to more employees employed by small businesses as those who work 20+ hours per week qualify for coverage versus 30+ hours per week under the ACA. It also promotes lower out-of-pocket costs for employees as no more than 1.5% of wages can be recouped for employee-only premiums versus 9.5% under the