Report Title:

Children's Health Care Program

Description:

Creates a temporary 3-year Hawaii children's health care program in which the DHS pays half the premiums for health care for uninsured children to a mutual benefit society, based on HMSA's children's plan model. Appropriates $        for FY 2006-2007. Repealed 6/30/09.

HOUSE OF REPRESENTATIVES

H.B. NO.

3116

TWENTY-THIRD LEGISLATURE, 2006

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to the hawaii children's health care program.

 

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

SECTION 1. Although estimates of the rate of uninsured children in the State vary, one thing that can be agreed upon is that there is a gap group that is ineligible for any state or federal health care coverage. Children who remain uninsured typically do not receive appropriate levels of medical care and prevention. Children who lack a source of care or must turn regularly to a hospital emergency department are unlikely to receive preventive care or early and regular management of acute or chronic health conditions.

A study performed by the Urban Institute, a nonpartisan economic and social policy research organization, showed that, regardless of age, race, ethnicity, income or health status, uninsured children were much less likely to have received a well-child checkup within the past year and were more likely than insured children to report an unmet need for medical care that was associated with concerns about cost.

Health insurance helps children and youth get regular health care so they can participate in school and other activities. Often parents experience hardship when a child is sick because of the added stress of medical bills if the child's health care costs are not covered.

The Hawaii Medical Service Association offers a children's plan that covers certain preventive services, immunizations, doctor visits, diagnostic tests, emergency care, mental health benefits, and some prescription drugs.

The State has the opportunity to enter into a unique public-private partnership with the Hawaii Medical Service Association to help those children in the gap group receive health care coverage. This partnership will allow the State to offer coverage to uninsured children under the Hawaii Medical Service Association's children's plan. The cost of the premium will be split equally between the Hawaii Medical Service Association and the State.

The purpose of this Act is to establish the Hawaii children's health care program, as a temporary three-year pilot program, to provide health care coverage to uninsured children.

SECTION 2. Hawaii children's health care program; three-year pilot program; establishment. (a) There is created the Hawaii children's health care program, as a temporary three-year pilot program, to provide health care coverage to uninsured children. The program shall provide health care coverage through a public-private partnership between the department of human services on behalf of the State and a mutual benefit society, operating in the State under chapter 432, Hawaii Revised Statutes, that offers accident and health or sickness insurance plans.

(b) To qualify for this program, a child shall:

(1) Be a Hawaii resident continually for at least six months and be between the ages of three months to eighteen years;

(2) Have been uninsured continually for at least six months; and

(3) Be ineligible to qualify for any other state or federal health care coverage.

(c) The Hawaii Medical Service Association's children's plan shall serve as the model health insurance plan for this program. Other mutual benefit societies may partner with the State to offer coverage to uninsured children; provided that the plan benefits shall be equal to or better than those offered in the Hawaii Medical Service Association's children's plan.

(d) For each child enrolled in the children's health care program offered by a mutual benefit society while this Act is in effect, the State, through the department of human services, and the mutual benefit society shall share equally the cost of the premiums.

(e) Payments shall be made by the State, through the department of human services, on a quarterly basis to any mutual benefit society offering the children's health care program.

(f) Each participating mutual benefit society shall provide a quarterly report to the department of human services and the legislature of the number of children enrolled in the children's health care program.

(g) The Hawaii children's health care program shall terminate on June 30, 2009.

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 2006-2007, for the Hawaii children's health care program pursuant to this Act. The sum appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2006, and shall be repealed on June 30, 2009.

INTRODUCED BY:

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