HI SB403

Establishes a state-level individual health insurance mandate requiring Hawaii taxpayers to maintain minimum essential coverage or pay a penalty of $695 annually (adjusted annually for inflation) or 2.5% of household income above the filing threshold, whichever is greater, effective January 1, 2018 through June 30, 2021.

Creates a state premium tax credit allowing qualified taxpayers with household income up to a specified percentage of federal poverty guidelines to claim a refundable tax credit for costs of purchasing qualified health plans, with specific limitations on credit amounts and filing deadlines.

Requires all health insurance policies issued or renewed in Hawaii (including those under HRS chapter 87A) to cover ten essential health care benefits: ambulatory services, emergency services, hospitalization, pregnancy/maternity care, mental health and substance use disorder services, prescription drugs, rehabilitation services, laboratory services, preventive/wellness services, and pediatric services including dental and vision care.

Mandates coverage for contraceptive methods and breastfeeding support (including breast pumps) without cost-sharing requirements for all health insurers, mutual benefit societies, and health maintenance organizations.

Prohibits health insurers from imposing preexisting condition exclusions, using gender to determine premiums, denying coverage to adult children until age 26, or discriminating against health care providers acting within their license scope.