Bill

HCR 176

SUPPORTING THE REACTIVATION OF, AND URGING THE GOVERNOR TO APPOINT MEMBERS TO, THE HAWAII HEALTH AUTHORITY TO PLAN FOR A TRANSITION TO A MAXIMALLY COST-EFFECTIVE SINGLE-PAYER HEALTH CARE SYSTEM FOR THE STATE, TO BE IMPLEMENTED AS SOON AS POSSIBLE AFTER WAIVERS HAVE BEEN OBTAINED TO CAPTURE ALL MAJOR SOURCES OF FEDERAL FUNDING FLOWING TO THE STATE THROUGH MEDICARE, MEDICAID, AND TRICARE.

2025 Regular Session Introduced by Terez Amato and 3 co-sponsors

Urges reactivating the Hawaii Health Authority to plan and transition Hawaii to a cost-efficient single-payer health system, pending federal waivers and a 2026 report.

Referred to HLT/HSH, FIN, referral sheet 22

#hawaiihealthauthority #single-payerhealthcaresystem

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Bill Summary · HCR 176

Summary of HCR176: Support for Reactivation of the Hawaii Health Authority and Plan for a Single-Payer System

Overview

HCR176 is a concurrent resolution introduced on March 7, 2025, urging the reactivation of the Hawaii Health Authority and requesting the Governor to appoint members. The resolution directs the Authority to plan for a transition to a maximally cost-effective single-payer health care system for Hawaii, to be implemented as soon as possible after waivers are obtained to capture all major sources of federal funding (Medicare, Medicaid, and Tricare). It sets a reporting deadline for progress and recommendations ahead of the 2026 legislative session.

Purpose and Intent

Reinvigorate the Hawaii Health Authority, which is described as established but currently inactive, to oversee planning for universal health care financing.
Promote a transition to a single-payer system that prioritizes administrative efficiency and cost containment, with the aim of reducing overall health care costs in Hawaii.
Leverage potential federal funding streams through waivers to maximize financial feasibility for a state-wide single-payer model.

Key Provisions

Urges the Governor to appoint members to the Hawaii Health Authority to lead the transition planning.
Requires implementation of a transition to a single-payer system as soon as waivers are obtained to capture major federal funding (Medicare, Medicaid, Tricare).
Directs the Hawaii Health Authority to prepare and submit a progress report and recommendations, including any proposed legislation, to the Legislature no later than 20 days before the convening of the Regular Session in 2026.
Transmits certified copies of the resolution to the Governor, the Director of Finance, and the Director of Human Services.

Background and Rationale (as stated in the bill)

Cites potential federal Medicaid funding fluctuations under the federal administration and Congress.
Asserts that a single-payer model could achieve substantial savings from reduced administrative costs, particularly through standardized global budgeting, simplified fee-for-service structures, and streamlined administration.
Claims possible health system savings could lower Medicaid and state employee/retiree costs, with projected reductions in total health care costs and state budget expenditures.

Affected Parties

Hawaii residents receiving health care funding (through potential future single-payer administration).
State government entities, notably the Hawaii Health Authority, the Governor, the Director of Finance, and the Director of Human Services.
Stakeholders in health care delivery and financing who would be impacted by a transition to a single-payer system.

Procedural and Timeline Aspects

Status: Referred to HLT/HSH and FIN (referral sheet 22).
Introduced: March 7, 2025.
Reporting deadline: Progress report and recommendations due no later than 20 days before the 2026 Regular Session convening.
Related: HR172 is a companion bill.

Bottom Line

HCR176 is a non-binding, concurrent resolution that aims to mobilize state leadership and resources to reactivate the Hawaii Health Authority and chart a path toward a cost-efficient single-payer health care system, contingent on securing federal funding waivers. It emphasizes administrative savings as the central mechanism and sets a concrete reporting deadline to inform future legislative action.

Compiled from official sources — confirm details with the bill’s official record.