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SR 167

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.

2026 Regular Session Introduced by Stanley Chang and 3 co-sponsors

Hawaii resolution directs governor to reactivate health authority to plan single-payer system consolidating Medicare, Medicaid, and TRICARE funding pending federal waivers.

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#hawaiihealthauthority #reactivation #single-payerhealthcaresystem
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Bill Summary · SR 167

Legislative bill overview

SR 167 is a non-binding resolution urging Hawaii's governor to reactivate and staff the Hawaii Health Authority, a previously established body tasked with planning a transition to a single-payer health care system for the state. The resolution specifically directs this authority to design a system that consolidates Medicare, Medicaid, and TRICARE funding into one state-administered program focused on cost-effectiveness.

Why is this important

Hawaii has long explored single-payer health care as a way to control costs and expand coverage. This resolution represents a formal legislative push to move from conceptual planning toward concrete action. If implemented, such a system could significantly reshape how 1.4+ million residents access and pay for health services, potentially reducing administrative overhead and out-of-pocket costs—though it would also require major federal waivers and represent a fundamental restructuring of insurance markets.

Potential points of contention

  • Federal authority limitations: States cannot unilaterally redirect Medicare and TRICARE funds; federal waivers are discretionary and uncertain, making the plan's feasibility dependent on federal approval that may be difficult or impossible to obtain
  • Implementation complexity and costs: Transitioning an entire state health system requires resolving provider contracts, benefit design, enrollment systems, and managing disruption—the upfront transition costs could be substantial and unpredictable
  • Market and labor effects: A single-payer system could reduce private insurance industry jobs in Hawaii, affect provider reimbursement rates, and face resistance from insurers, employers, and providers with financial stakes in the current system

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

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