HI HB1490

Establishes "Hawaii Care," a universal single-payer health care system to provide comprehensive coverage for all Hawaii residents, replacing Medicare, Medicaid, and the Prepaid Health Care Act once federal waivers are obtained

Requires the Hawaii Health Authority to develop a comprehensive implementation plan including eligibility requirements, financing mechanisms, a 5-year business plan with fiscal projections, and annual budget proposals for all hospitals

Mandates coverage with 95% actuarial value including hospital, surgical, medical, dental (2 cleanings/exams per year), vision, hearing, mental health, substance abuse, prescription drugs, emergency services, and preventive care with no cost sharing except up to $30 maximum

Funds hospitals through global operating budgets based on operational costs rather than fee-for-service billing, while independent providers receive fee-for-service payments based on a standardized schedule negotiated annually

Appropriates $350,000 for each of fiscal years 2025-2026 and 2026-2027 for Hawaii Health Authority administration, with the program taking effect 180 days after CMS approves the state Medicaid plan amendment