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SR 109

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 Stanley Chang and 2 co-sponsors

Hawaii urges governor to develop single-payer healthcare plan consolidating Medicare, Medicaid, and TRICARE funding after obtaining federal waivers.

Referred to HHS, WAM.
#hawaiihealthauthority #single-payerhealthcaresystem
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Bill Summary · SR 109

Legislative bill overview

SR 109 is a resolution urging Hawaii's governor to reactivate the Hawaii Health Authority and appoint members to develop a comprehensive plan for transitioning the state to a single-payer health care system. The system would consolidate Medicare, Medicaid, and TRICARE funding to create a unified, state-administered health insurance program, contingent on obtaining federal waivers.

Why is this important

Hawaii would become a test case for single-payer health care implementation at the state level, potentially affecting coverage for hundreds of thousands of residents and restructuring how federal health dollars are administered. The proposal could reduce administrative complexity and overhead costs, but would require significant federal approval and fundamental restructuring of existing health insurance arrangements in the state.

Potential points of contention

  • Federal waiver feasibility: Obtaining waivers to redirect Medicare, Medicaid, and TRICARE funding requires approval from multiple federal agencies (CMS, DoD) with uncertain political viability and complex legal requirements
  • Implementation timeline and costs: Transitioning an entire state health system involves substantial upfront costs, system redesign, and potential service disruptions that may not materialize "as soon as possible"
  • Provider network impacts: Consolidating payers under a single system could reduce provider choice, alter reimbursement rates, and create resistance from hospitals, physicians, and insurance industry stakeholders
  • Coverage and benefit design questions: The resolution doesn't specify what benefits would be covered or how provider payments would be determined, leaving critical policy details undefined

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

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