Hawaii Lawmakers React to Recent Decision To End State Universal Health Care Program for Children

Hawaii state legislators and Hawaii Medical Service Association officials last week criticized actions by Gov. Linda Lingle's (R) administration last week to end funding for Keiki Care, the state's universal health care program for children, the Honolulu Star-Bulletin reports (Altonn, Honolulu Star-Bulletin, 10/17). Beginning Nov. 1, the state no longer will provide funding for the 2,000 children enrolled in the program, but private partner HMSA will pay to cover the children through the end of 2008.

Lingle, who signed the program into law in 2007, said a state budget shortfall prompted the funding cut. Hawaii faces a projected $900 million general fund deficit by 2011. The state contributed about $50,000 monthly, or $25.50 per child, to the program, and HMSA provided additional funding. All uninsured children up to age 18 were eligible for the program and it essentially was available at no cost for participants except for a $7 copayment for physician office visits (Kaiser Daily Health Policy Report, 10/17).

Cliff Cisco, senior vice president of HMSA, said, "We're just kind of shocked, really, that they made this sudden and precipitous decision." He said, "I hope the state would continue its commitment to the program," adding, "The main thing is our commitment to the families who have children enrolled in it."

State Department of Human Services officials cited several reasons for the decision to end the collaboration with HMSA, including increased enrollment in state Medicaid programs -- to about 108,000 individuals; the "limited success" of Keiki Care in providing coverage to uninsured children in families whose income is too high to qualify for Medicaid; and the lack of federal matching funds available for the program. According to DHS, about 85% of children in Keiki Care previously were covered by HMSA's Children's Plan and families with children affected by the decision are being encouraged to enroll in the HMSA plan, which costs about $55 per month.

State House Health Committee Chair Josh Green (D), along with state Senate Human Services and Housing Committee Chair Suzanne Chun Oakland (D), a key supporter of the law, said the Lingle administration should have conferred with the Legislature about the decision. DHS spokesperson Toni Schwartz said, "We're hoping HMSA will keep the Keiki Care program on its own without involving the state," and suggested that HMSA should charge the same $25.50 fee that the state paid for each child under Keiki Care (Honolulu Star-Bulletin, 10/17).