Note on source documents
- The bill metadata supplied at top (designating “AKA Day” in Delaware) conflicts with the full text supplied. The full text and legislative history below describe Hawaii HCR 39 — a concurrent resolution directing Hawaii health agencies to study uninsured children and the costs/feasibility of expanding Med‑QUEST coverage. This summary follows the actual resolution text and legislative actions provided.
Title
- HCR 39 (Hawaii, 2025) — Concurrent resolution requesting data collection, cost estimates, and policy proposals to move toward universal health insurance coverage for children in the State.
Purpose / Intent
- To obtain up‑to‑date counts and claims data on uninsured children in Hawaii, estimate state costs of expanding continuous Med‑QUEST (Medicaid) coverage for children, identify children ineligible under federal (CMS) rules, and request interagency policy recommendations (including proposed legislation) to achieve universal child health coverage.
Key findings cited in preamble
- U.S. Census Bureau 2024 estimates: about 3.6% of Hawaii children (birth–18) lack health insurance statewide; up to 9% on Hawaii Island and 5% on Maui.
- Current Hawaii policy: if a child qualifies for Medicaid at any time birth–age 6, they get continuous coverage through age 6; if they qualify after age 6, they receive continuous coverage for two years.
Major provisions / requests
1. Health Data Advisory Council (State Health Planning & Development Agency)
- Confirm the number of uninsured children statewide and by county in 2025.
- Examine at least 60 days of de‑identified, privacy‑assured hospital and emergency department claims or discharge data (including potential impacts of CMS coverage policy changes).
Med‑QUEST Division (Department of Human Services)
- Estimate the state (Hawaii) cost to increase coverage for children aged 6–18 from the current two years of continuous coverage after eligibility to up to 12 years of continuous coverage, as necessary.
- Estimate the number of uninsured and underinsured children (birth–18) who are ineligible for Med‑QUEST solely due to CMS regulations, and estimate the state cost to cover these children.
Collaboration and policy proposals
- Med‑QUEST and the State Health Planning & Development Agency are asked to collaborate to propose policy changes needed to achieve universal child coverage, taking into account federal Medicaid funding or policy changes.
Reporting and recipients
- Submit a report with data, findings, recommendations, and any proposed legislation to the Legislature no later than 20 days before the convening of the Regular Session of 2026.
- Transmit certified copies of the resolution to the Agency Administrator, Med‑QUEST Administrator, and Chair of the Health Data Advisory Council.
Who would be affected
- Primary: uninsured, underinsured, and potentially Medicaid‑eligible children in Hawaii (birth–18).
- Secondary: State agencies (Med‑QUEST; State Health Planning & Development Agency; Health Data Advisory Council), the Legislature (for any follow‑on legislation), and state budget (if coverage expansions are recommended).
Procedural status / timeline
- Introduced: January 6, 2025 (filed).
- Passed House and Senate in 2025 (voice votes and roll calls recorded); enrolled and signed by presiding officers; presented to Secretary of State May 9, 2025.
- Required reporting: agencies must deliver their report 20 days prior to the Regular Session of 2026.
Potential impacts / considerations
- The requested analyses would quantify uninsured children and estimate state budget impacts of extended continuous coverage (up to 12 years for ages 6–18) and of covering children ineligible due to federal rules.
- Any recommended expansion that increases state spending would require legislative and budgetary action; federal Medicaid match rules and potential CMS policy changes are significant factors for cost and feasibility.
- The 60‑day claims review could identify utilization patterns and cost‑drivers among uninsured children, informing targeted policy options.
Sponsors and related measures
- Sponsors (as listed): Takayama, Amato, Keohokapu‑Lee Loy, Reyes Oda, Marten, Olds, Perruso; author Matt Lehman; Senate sponsor Travis Holdman. Cosponsors include Vanessa Caston LaFleur, Delisha Boyd.
- Related bills: SCR 6 (companion), HR 34 (companion).
