272476 Hawaii: Transitioning and moving beyond ACA

Monday, October 29, 2012 : 3:00 PM - 3:15 PM

Stephen Kemble, MD , Psychiatric Associates L td., Honolulu, HI
In 2009, the Hawaii Legislature enacted a law to create the Hawaii Health Authority, a board charged with overall health planning for the state and with developing a comprehensive health system covering everyone in Hawaii. The HHA submitted a report to the Governor and Legislature in December 2011 that includes a summary of Hawaii's Medicaid managed care problems, eight “Principles for Cost-Effective, Sustainable Health Care Reform,” a strategic plan to steer Hawaii from the present situation to a universal single-payer system, including transitional use of features of the Affordable Care Act such as a Health Insurance Exchange and use of Hawaii's Medicaid waiver, and a summary of the cost implications of a fully implemented universal system. The next task for the HHA is to develop specific legislation for implementation of this plan. Hawaii's Governor also established a “Health Transformation Initiative” to bring various stakeholders together, and the HHA report is being used as a guiding vision for this process. I will be discussing the obstacles being confronted as this process unfolds and the advantages of starting with a high-level administrative structure with a guiding vision and principles before development of specific legislative language.

Learning Areas:
Administration, management, leadership
Provision of health care to the public
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Describe initiation and development of plans under the Hawaii Health Authority. 2. Analyze the transition and difficulties from Medicaid managed care toward single-payer. 3. Explain plans for using ACA provisions to move toward single-payer, universal care. 4. Assess the involvement of the Governor and other high-level players.

Keywords: Access to Health Care, Health Insurance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Assistant Professor of Medicine, University of Hawaii School of Medicine. I have a strong interest in health care reform and health system design and have been involved in peer review for hospitals and health plans throughout my career. I've also published op-eds in local papers and online, as well as delivered talks on health care reform in various settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.