S.R. No. 109 Summary

• Urges the Governor to reactivate the Hawaii Health Authority and appoint members to plan a transition to a single-payer health care system for Hawaii.

• Proposes implementing the single-payer system after obtaining federal waivers to consolidate Medicare, Medicaid, and Tricare funding streams.

• Projects potential cost savings of approximately 30 percent through reduced administrative costs in hospital billing, physician practice operations, and system administration.

• Recommends using savings to fund community-based programs for high-risk patients and increase physician compensation in under-paid specialties to address physician shortage.

• Requires the Hawaii Health Authority to submit a progress report and recommendations, including proposed legislation, to the Legislature by 20 days before the 2026 Regular Session.