Bill Text: HI SB1120 | 2018 | Regular Session | Introduced
Bill Title: Relating To Health Care Insurance.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2017-11-30 - Carried over to 2018 Regular Session. [SB1120 Detail]
Download: Hawaii-2018-SB1120-Introduced.html
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THE SENATE |
S.B. NO. |
1120 |
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TWENTY-NINTH LEGISLATURE, 2017 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to health care insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. The legislature finds that it is in the best interest of the State for every state citizen to have publicly provided, high quality, affordable health care. Health care is more than just medical insurance payouts - it includes cost-saving, preventive, and early intervention measures to prohibit medical conditions from becoming chronic, permanently disabling, or fatal.
The legislature further finds that health care rates are skyrocketing, creating an affordability and accessibility crisis for Hawaii residents. Hawaii's current health care insurance system is a disjointed, costly, inefficient, and unnecessarily complicated, multi-payer, private medical insurance model that is mostly profit-driven, adversarial, beset with constant cost-shifting and reluctant health care delivery, onerously bureaucratic, and economically irrational.
The legislature recognizes that two of the biggest cost-drivers of health care today are:
(1) The profit-driven complex of payment-reluctant, multi-payer health insurance bureaucracies competing to insure only the healthy and wealthy, while leaving those who need health care the most to the taxpayers; and
(2) The high cost of prescription drugs.
The legislature further finds that for more than a quarter of a century, Hawaii was far ahead of most other states and often called itself "the health state" because of the 1974 Hawaii Prepaid Health Care Act. Hawaii was once known for having a low uninsured population of between two and five per cent in 1994.
However, the crisis in health care facing the nation has also befallen Hawaii. Today, thousands of Hawaii citizens lack health care coverage, many of whom are children. Many other Hawaii residents are underinsured, unable to use their insurance properly, or even at all, because of increasingly expensive deductibles and out-of-pocket co-payments for outpatient visits, diagnostic tests, and prescription drugs, among other factors. Even well-insured individuals experience problems with their insurers denying, or very reluctantly dispensing, expensive medicines and treatments. About half of all bankruptcies are due to extremely expensive, catastrophic illnesses that are not covered after a certain cap is reached. Other individuals and families struggling to avoid bankruptcy have a deteriorated quality of life due to financial stress.
The legislature further finds that a universal, publicly administered, health care-for-all insurance model with one payout agency for caregivers and providers, adapted to meet the unique conditions in Hawaii, would be beneficial for the following reasons:
(1) For union members and their employers, it means taking health care off the negotiating table;
(2) For patients, as taxpayers and insurance premium-payers, it means significant reductions in overall costs, increases in benefits, and the slowing of annual inflation cost increases. It also means a comeback from increasingly uncaring, profit-driven health care to the restoration of human-need-driven, mutually respectful, and caring patient-doctor-nurse-and other caregiver relationships, which in the past were fundamental to meaningful health care;
(3) For businesses, large and small, it reduces significant overhead expenses;
(4) For the local economy, it means keeping almost all health care dollars in the State;
(5) For government, it means having one integrated, electronic, health information database for unprecedented planning and cost-containment capabilities. It also means relief from the perceived emerging problem of unfunded liabilities associated with long-term funding of government retiree health care benefits;
(6) For physicians, nurses, and other caregivers, it means less paperwork, less work stress, and more time with patients;
(7) For hospitals, community health clinics, homecare providers, and long-term care facilities, it means sufficient and dependable annual financing through global budgets; and
(8) For the public, it means accessible and affordable health care for every person, and relief from the stresses of constant worry over the instability of health care coverage.
The purpose of this Act is to create a unified, single-payer, universal health care system covering all Hawaii residents.
SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:
"Chapter
single-payer universal health care system
§ -1 Single-payer universal health care insurance system; established. There is established the single-payer universal health care insurance system to provide the same high-quality level of medically necessary health care to all Hawaii citizens. Private health care insurers shall not duplicate the coverages provided by the single-payer universal health care insurance system.
§ -2 State health care insurance planning and financing authority. (a) There is established within the department of health, for administrative purposes, the state health care insurance planning and financing authority to determine the costs of the system and to gather the needed financing methods and transition mechanisms.
(b) Notwithstanding any law to the contrary, effective July 1, 2019, the functions of the Hawaii health authority; the department of labor and industrial relations as they relate to chapter 393, the Hawaii Prepaid Health Care Act; and the Hawaii employer-union health benefits trust fund under chapter 87A shall be transferred to the state health care insurance planning and financing authority, and these functions shall be maintained until fully integrated into the system by the state health care insurance planning and financing authority.
(c) 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 members shall be appointed for terms of four years each. One member shall be selected to be the executive director and confirmed by a majority vote of a quorum of the members of the state health care insurance planning and financing authority.
(d) Five members shall constitute a quorum, whose affirmative vote shall be necessary for all valid actions by the authority.
(e) The state health care insurance planning and financing authority shall:
(1) Begin and maintain a trust fund comprised of a pay-as-we-go transfer payments system and a reserve fund;
(2) Negotiate and receive all federal, state, and other appropriate health care revenue;
(3) Assess temporary surcharges on the income and general excise taxes for start-up and emergency costs as necessary, for instance, during epidemic or other medical catastrophes;
(4) Be the single payer of universal health care financing for Hawaii;
(5) Hire a chief executive officer who shall be accountable for the development and success of the single-payer universal health care system and other staff as necessary; and
(6) Conduct a continuous and ongoing program of enrollment.
(e) The concurrence of a majority of all directors shall be necessary to make any action of the authority valid.
(f) The salary of the executive director shall be $ a year, and the salaries of the other members shall be $ a year."
SECTION 3. Chapter 322H, Hawaii Revised Statutes, is repealed.
SECTION 4. All rights, powers, functions, and duties of the Hawaii health authority, department of labor and industrial relations as they relate to the Hawaii Prepaid Health Care Act, and Hawaii employer-union benefits trust fund are transferred to the state health care insurance planning and financing authority.
All officers and employees whose functions are transferred by this Act shall be transferred with their functions and shall continue to perform their regular duties upon their transfer, subject to the state personnel laws and this Act.
No officer or employee of the State having tenure shall suffer any loss of salary, seniority, prior service credit, vacation, sick leave, or other employee benefit or privilege as a consequence of this Act, and such officer or employee may be transferred or appointed to a civil service position without the necessity of examination; provided that the officer or employee possesses the minimum qualifications for the position to which transferred or appointed; provided further that subsequent changes in status may be made pursuant to applicable civil service and compensation laws.
An officer or employee of the State who does not have tenure and who may be transferred or appointed to a civil service position as a consequence of this Act shall become a civil service employee without the loss of salary, seniority, prior service credit, vacation, sick leave, or other employee benefits or privileges and without the necessity of examination; provided that such officer or employee possesses the minimum qualifications for the position to which transferred or appointed.
If an office or position held by an officer or employee having tenure is abolished, the officer or employee shall not thereby be separated from public employment, but shall remain in the employment of the State with the same pay and classification and shall be transferred to some other office or position for which the officer or employee is eligible under the personnel laws of the State as determined by the head of the department or the governor.
SECTION 5. All appropriations, records, equipment, machines, files, supplies, contracts, books, papers, documents, maps, and other personal property made, used, acquired, or held by the department of labor and industrial relations regarding the Hawaii Prepaid Health Care Act, Hawaii health authority, and Hawaii employer-union benefits trust fund relating to the functions transferred to the state health care insurance planning and financing authority shall be transferred with the functions to which they relate.
SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2017-2018 and the same sum or so much thereof as may be necessary for fiscal year 2018-2019 for establishment of the state health care insurance planning and financing authority to operate a single-payer universal health care insurance system.
The sums appropriated shall be expended by the department of health for the purposes of this Act.
SECTION 7. This Act shall take effect on July 1, 2017.
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INTRODUCED BY: |
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Report Title:
Health Care; Single-payer Universal Health Care Insurance System; State Health Care Insurance Planning and Financing Authority; Appropriation
Description:
Establishes the single-payer universal health care insurance system to provide the same high-quality level of medically necessary health care to all Hawaii citizens. Prohibits private health care insurers from duplicating the coverages provided by the system. Establishes the state health care insurance planning and financing authority within the department of health to operate the system. Provides the structure and duties of the authority. Requires that the functions, rights, powers, duties, and appropriations of the Hawaii health authority, DLIR as they relate to the Hawaii Prepaid Health Care Act, and Hawaii employer union health benefits trust fund be transferred to the state health care insurance planning and financing authority. Repeals the Hawaii health authority. Appropriates funds to the state health care insurance planning and financing authority to establish and operate the single-payer universal health care insurance system.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
