Bill Text: HI HB2033 | 2022 | Regular Session | Introduced

Hawaii House Bill 2033 (Prior Session Legislation)

HI State Legislature page for HB2033

Introduced

Bill Title: Relating To Health.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2022-01-28 - Referred to HHH, LMG, FIN, referral sheet 3 [HB2033 Detail]

Download: Hawaii-2022-HB2033-Introduced.html

HOUSE OF REPRESENTATIVES	H.B. NO.	2033
THIRTY-FIRST LEGISLATURE, 2022
STATE OF HAWAII

A BILL FOR AN ACT

relating to Health.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that Hawaii has long been a leader in advancing medical services and health care, advocating the importance of access to health care without discrimination, and implementing forward-thinking health care policy such as the Hawaii Prepaid Health Care Act of 1974. It is in the best interest of the State for each and every employer-union health benefits trust fund beneficiary to have publicly provided, high quality, and affordable health care.

Health care involves more than just medical insurance payouts, but also includes cost-saving preventative and early intervention measures, dental services, and mental illness treatment to prevent medical health conditions from becoming chronic, permanently disabling, or fatal. Under Hawaii's current health care insurance system, patients encounter many challenges to their medical care, including requirements for prior authorizations, formulary restrictions, and networks with limited physician participation. This system also burdens physicians and hospitals with administrative demands such as pay for performance, pay for documentation, and capitation, all of which require much more detailed documentation and data reporting while controlling and restricting payment for primary care in particular, which results in physicians being driven out of practice or leaving the State.

The legislature further finds that health care rates are skyrocketing, creating an affordability and accessibility crisis for Hawaii's residents. The two largest cost drivers of health care in the United States and Hawaii are high administrative costs due to reliance on a competitive insurance business model and the high cost of prescription drugs. 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 Prepaid Health Care Act and for having a low percentage of residents without health insurance, which in 1994 was between two and five per cent.

The legislature also finds that as a result of the COVID-19 pandemic, thousands of Hawaii residents have lost their jobs and health insurance, making it critical for the State to support struggling families by ensuring preventative care and limiting out-of-pocket costs. The safeguarding of access to health care, solidification of the essential health benefits that have changed thousands of lives, and improvement of overall access to care requires the preservation of certain important aspects of the federal Patient Protection and Affordable Care Act and the expansion of access to care for residents of Hawaii.

Accordingly, the purpose of this Act is to require the auditor to conduct a comprehensive study of the health insurance plans in the State that administer the Hawaii employer-union health benefits trust fund.

SECTION 2. (a) The auditor shall conduct a study that includes:

(1) A financial analysis of the health insurance plans that administer the Hawaii employer-union health benefits trust fund to assess the medical loss ratio by auditing:

(A) Amounts paid for direct health care services, including laboratory and other testing services;

(B) Amounts paid for quality improvement under the federal Patient Protection and Affordable Care Act; and

(i) Medical management administrative costs;

(ii) Payment reform administrative costs; and

(iii) Payments to providers of health care; and

(2) An analysis of the effects of payment reforms, particularly payments to primary care physicians, including:

(A) How capitation payments impact administrative costs and burdens of physicians' practices and contribute to the State's physician shortage; and

(B) An assessment of the financial prudence of having managed care organizations administer the employer-union health benefits trust fund based on the amount paid for health care and the amount paid for administrative services in the State.

(b) The auditor shall submit a report of its findings and recommendations, including any proposed legislation, to the legislature no later than twenty days prior to the convening of the regular session of 2023.

SECTION 3. 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 2022-2023 for a comprehensive study of the health insurance plans in the State that administer the Hawaii employer-union health benefits trust fund.

The sum appropriated shall be expended by the auditor for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2022.

INTRODUCED BY:	_____________________________

Report Title:

Auditor; Study; EUTF; Health Insurance Plans

Description:

Requires auditor to conduct a comprehensive study of the health insurance plans in the State that administer the Hawaii employer-union health benefits trust fund.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.