HB 1490 Summary

• Establishes "Hawaii Care," a universal single-payer health care system administered by the Hawaii Health Authority to eventually replace Medicare, Medicaid, and the Prepaid Health Care Act once federal waivers are approved.

• Requires the Hawaii Health Authority to develop a comprehensive plan including eligibility criteria, financing mechanisms, benefits packages, hospital budgets, and provider payment schedules for the universal health care system.

• Mandates coverage of extensive health benefits including hospital, surgical, medical, dental, vision, hearing, mental health, substance abuse, pharmacy, and preventive care services without cost sharing except for a maximum $30 copayment.

• Establishes funding through a Hawaii Care special fund supported by legislative appropriations, gifts, donations, and federal grants; appropriates $350,000 annually for fiscal years 2025-2026 and 2026-2027 for administration.

• Requires the Department of Human Services to apply for necessary Medicaid plan amendments and Section 1332 waivers from the Patient Protection and Affordable Care Act; Hawaii Care takes effect 180 days after Medicaid approval on July 1, 2025.