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SCR 201

SUPPORTING THE REACTIVATION OF THE HAWAII HEALTH AUTHORITY WITH STATUTORY MANDATES THAT SPECIFICALLY INCLUDE THE TRANSITION OF THE STATE'S HEALTH INSURANCE PAYMENT SYSTEM INTO A SINGLE-PAYER HEALTH CARE SYSTEM.

2025 Regular Session Introduced by Mike Gabbard

Reactivates the Hawaii Health Authority to pursue a transition to a single-payer health system after obtaining waivers and exhausting federal funds.

Referred to HHS/CPN .
#hawaiihealthauthority #legislature #medicaid #medicare #single-payerhealthcaresystem #tricare #waivers
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Bill Summary · SCR 201

SCR 201 Summary — Hawaii Concurrent Resolution

Overview

SCR 201 is a concurrent resolution introduced in the Hawaii Legislature on March 7, 2025 and referred to the Health, Human Services, and Commerce/Consumer Protection and Commerce committees (HHS/CPN). Its purpose is to support reactivating the Hawaii Health Authority (HHA) with statutory mandates to transition the state’s health insurance payment system to a single-payer system, to be implemented after obtaining waivers for Medicare, Medicaid, and Tricare and exhausting all sources of federal funding.

Purpose and Intent

  • Recommends reactivating the Hawaii Health Authority (HHA), which previously existed under Act 11 (Special Session Laws of Hawaii 2009) and is codified at chapter 322H, Hawaii Revised Statutes, but is currently inactive.
  • Specifically mandates that the reactivated HHA include a pathway to transition the State’s health insurance payment system into a single-payer health care system.
  • Requires implementation only after: (a) waivers for Medicare, Medicaid, and Tricare are obtained; and (b) all sources of federal funding for these programs have been exhausted.

Key Provisions (What the Resolution Says)

  • Expresses concern about potential federal Medicaid funding cuts under the federal government and frames a single-payer system as a cost-saving alternative.
  • Describes anticipated administrative savings from a single-payer system, including:
    • Hospitals: reduction of billing and collections costs (estimated nationwide around 15% of hospital budgets).
    • Independent physicians: simplified, standardized fee-for-service structure, reducing billing costs (also estimated around 15% of physician practice revenue nationwide).
    • Establishment of a single-payer administrator in the State to achieve similar administrative savings.
  • Proposes using administrative savings to:
    • Fund community-based programs for high-risk and special-needs patients.
    • Support specialist consultations for primary care to reduce preventable emergency room visits and hospitalizations.
    • Improve take-home pay for primary care physicians and psychiatrists to address physician shortages and high living costs.
  • Projects potential overall impact on state finances:
    • Health care costs for Medicaid and state/county employee/retiree benefits comprise about 30% of the state budget.
    • Administrative savings could reduce state health care costs by roughly 30% or more, with a resulting approximate 9% reduction in the total state budget.
  • Transmission of certified copies to key state officials: Director of Health, Director of Budget and Finance, and Insurance Commissioner.

Affected Parties and Impacts

  • State government and budgets (potential reductions in health care costs and overall budget impact).
  • Hawaii Health Authority (to be reactivated with an explicit mandate to pursue single-payer transition).
  • Health care providers (potential changes in payment models and administrative requirements).
  • Medicare, Medicaid, Tricare programs (waivers required before implementation).

Process and Timeline

  • Status: Referred to HHS/CPN (as of March 12, 2025); introduced March 7, 2025.
  • Procedural note: As a concurrent resolution, it expresses legislative intent and guidance rather than creating binding law.
  • Next steps would involve committee action, potential amendments, and broader floor consideration.

Related Legislation

  • Companion bill: SR 161 (mentioned as related).

This summary aims to clearly convey SCR 201’s goals, the proposed path to a single-payer system, and the fiscal and administrative implications outlined in the bill.

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

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