HI HR180

Urges the Governor to determine a course of action for Hawaii should the federal government cut Medicaid funding, particularly in response to a February 2025 House budget resolution proposing over $800 billion in Medicaid reductions over ten years.

Requests the Governor consult with Hawaii's congressional delegation to determine impacts of pending federal legislation on Medicaid expansion and timing of any funding reductions.

Requests the Governor submit a report with findings, recommendations, and proposed legislation to the Legislature no later than twenty days before the 2026 Regular Session convening.

Highlights that Hawaii's Med-QUEST program serves approximately one in five residents and received $3 billion in total Medicaid spending in fiscal year 2023, with 73 percent federally funded.

Notes that under scenarios eliminating the federal ACA expansion match rate, Hawaii could lose between $320 million to $9.4 billion annually in federal funding, and potentially 156,000 Medicaid enrollees (34 percent of total population) could lose coverage.