Hawaii 2022 Regular Session

Hawaii House Bill HR133 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	HOUSE OF REPRESENTATIVES H.R. NO. 133 THIRTY-FIRST LEGISLATURE, 2022 STATE OF HAWAII HOUSE RESOLUTION requesting the legislative reference bureau to conduct a financial analysis of the managed care organizations that administer the employeR-union health benefits trust fund by auditing the amounts paid for health care and amounts paid for administrative services.
2	2
3	3	HOUSE OF REPRESENTATIVES H.R. NO. 133
4	4	THIRTY-FIRST LEGISLATURE, 2022
5	5	STATE OF HAWAII
6	6
7	7	HOUSE OF REPRESENTATIVES
8	8
9	9	H.R. NO.
10	10
11	11	133
12	12
13	13	THIRTY-FIRST LEGISLATURE, 2022
14	14
15	15
16	16
17	17	STATE OF HAWAII
18	18
19	19
20	20
21	21
22	22
23	23
24	24
25	25
26	26
27	27
28	28
29	29	HOUSE RESOLUTION
30	30
31	31
32	32
33	33
34	34
35	35	requesting the legislative reference bureau to conduct a financial analysis of the managed care organizations that administer the employeR-union health benefits trust fund by auditing the amounts paid for health care and amounts paid for administrative services.
36	36
37	37
38	38
39	39
40	40
41	41
42	42
43	43	WHEREAS, Hawaii has long been a leader in advancing medical services and health care, advocating the importance of access to health care without discrimination, and implementing forward-thinking health care policies, such as the Prepaid Health Care Act of 1974; and WHEREAS, it is in the best interest of the State for every Employer-Union Health Benefits Trust Fund beneficiary to have publicly provided, high-quality, and affordable health care; and WHEREAS, health care involves more than just medical insurance payouts and also includes cost-saving preventive and early intervention measures, dental coverage, and mental illness treatment to prevent medical health conditions from becoming chronic, permanently disabling, or fatal; and WHEREAS, under Hawaii's existing health care insurance system, health insurance companies have used their unilateral control over how health care is organized and paid for to erect obstacles to care for patients through excessive prior authorizations, formulary restrictions, and networks with limited physician participation; and WHEREAS, this system also burdens physicians and hospitals with administrative demands, such as pay for performance, pay for documentation, and capitation, all of which require much more detailed documentation and data reporting while controlling and restricting payment for primary care in particular, which results in physicians being driven out of practice or leaving the State; and WHEREAS, health care rates are skyrocketing, creating an affordability and accessibility crisis for Hawaii's residents; and WHEREAS, the two largest cost drivers of health care in the United States and Hawaii are: (1) High administrative costs due to reliance on a competitive insurance business model that incentivizes denial and obstruction of care, micromanagement of doctors and hospitals, and attempts to avoid covering or paying for sicker and socially disadvantaged patients and populations, resulting in disparities in access to care; and (2) The high cost of prescription drugs; and WHEREAS, for more than a quarter of a century, Hawaii was far ahead of most other states, often calling itself the "Health State" because of the Hawaii Prepaid Health Care Act of 1974, and was once known for having a low percentage of residents without health insurance, which was between two and five percent in 1994; and WHEREAS, as a result of the coronavirus disease 2019 pandemic, thousands of Hawaii residents have lost their jobs and health insurance, making it critical for the State to support struggling families by ensuring preventive care and limiting out-of-pocket costs; and WHEREAS, the safeguarding of access to health care, solidification of the essential health benefits that have changed thousands of lives, and improvement of overall access to care requires the preservation of certain important aspects of the federal Patient Protection and Affordable Care Act and the expansion of access to care for residents of Hawaii; and WHEREAS, negotiations between the health insurance industry and the Obama Administration in 2011 allowed health insurance plans to reclassify "medical management" costs as health care instead of administrative costs for the purposes of reporting medical loss ratios, enabling large administrative costs to be hidden; now, therefore, BE IT RESOLVED by the House of Representatives of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2022, that the Legislative Reference Bureau is requested to conduct a financial analysis of the managed care organizations that administer the Employer-Union Health Benefits Trust Fund by auditing the amounts paid for health care and amounts paid for administrative services; and BE IT FURTHER RESOLVED that in its financial analysis, the Legislature Reference Bureau is requested to: (1) Conduct an analysis of the effects of payment reforms and payment of primary care physicians with capitation on practice administrative costs and burdens and their contributions to Hawaii's physician shortage; (2) Analyze "medical management" administrative costs and the administrative cost of payment reforms from payments to providers for provision of health care; and (3) Investigate other issues it deems relevant; and BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2023; and BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of the Legislative Reference Bureau and Administrator of the Hawaii Employer-Union Health Benefits Trust Fund. OFFERED BY: _____________________________ Report Title: Legislative Reference Bureau; Employer-Union Health Benefits Trust Fund; Financial Analysis
44	44
45	45	WHEREAS, Hawaii has long been a leader in advancing medical services and health care, advocating the importance of access to health care without discrimination, and implementing forward-thinking health care policies, such as the Prepaid Health Care Act of 1974; and
46	46
47	47
48	48
49	49	WHEREAS, it is in the best interest of the State for every Employer-Union Health Benefits Trust Fund beneficiary to have publicly provided, high-quality, and affordable health care; and
50	50
51	51
52	52
53	53	WHEREAS, health care involves more than just medical insurance payouts and also includes cost-saving preventive and early intervention measures, dental coverage, and mental illness treatment to prevent medical health conditions from becoming chronic, permanently disabling, or fatal; and
54	54
55	55
56	56
57	57	WHEREAS, under Hawaii's existing health care insurance system, health insurance companies have used their unilateral control over how health care is organized and paid for to erect obstacles to care for patients through excessive prior authorizations, formulary restrictions, and networks with limited physician participation; and
58	58
59	59
60	60
61	61	WHEREAS, this system also burdens physicians and hospitals with administrative demands, such as pay for performance, pay for documentation, and capitation, all of which require much more detailed documentation and data reporting while controlling and restricting payment for primary care in particular, which results in physicians being driven out of practice or leaving the State; and
62	62
63	63
64	64
65	65	WHEREAS, health care rates are skyrocketing, creating an affordability and accessibility crisis for Hawaii's residents; and
66	66
67	67
68	68
69	69	WHEREAS, the two largest cost drivers of health care in the United States and Hawaii are:
70	70
71	71
72	72
73	73	(1) High administrative costs due to reliance on a competitive insurance business model that incentivizes denial and obstruction of care, micromanagement of doctors and hospitals, and attempts to avoid covering or paying for sicker and socially disadvantaged patients and populations, resulting in disparities in access to care; and
74	74
75	75
76	76
77	77	(2) The high cost of prescription drugs; and
78	78
79	79
80	80
81	81	WHEREAS, for more than a quarter of a century, Hawaii was far ahead of most other states, often calling itself the "Health State" because of the Hawaii Prepaid Health Care Act of 1974, and was once known for having a low percentage of residents without health insurance, which was between two and five percent in 1994; and
82	82
83	83
84	84
85	85	WHEREAS, as a result of the coronavirus disease 2019 pandemic, thousands of Hawaii residents have lost their jobs and health insurance, making it critical for the State to support struggling families by ensuring preventive care and limiting out-of-pocket costs; and
86	86
87	87
88	88
89	89	WHEREAS, the safeguarding of access to health care, solidification of the essential health benefits that have changed thousands of lives, and improvement of overall access to care requires the preservation of certain important aspects of the federal Patient Protection and Affordable Care Act and the expansion of access to care for residents of Hawaii; and
90	90
91	91
92	92
93	93	WHEREAS, negotiations between the health insurance industry and the Obama Administration in 2011 allowed health insurance plans to reclassify "medical management" costs as health care instead of administrative costs for the purposes of reporting medical loss ratios, enabling large administrative costs to be hidden; now, therefore,
94	94
95	95
96	96
97	97	BE IT RESOLVED by the House of Representatives of the Thirty-first Legislature of the State of Hawaii, Regular Session of 2022, that the Legislative Reference Bureau is requested to conduct a financial analysis of the managed care organizations that administer the Employer-Union Health Benefits Trust Fund by auditing the amounts paid for health care and amounts paid for administrative services; and
98	98
99	99
100	100
101	101	BE IT FURTHER RESOLVED that in its financial analysis, the Legislature Reference Bureau is requested to:
102	102
103	103
104	104
105	105	(1) Conduct an analysis of the effects of payment reforms and payment of primary care physicians with capitation on practice administrative costs and burdens and their contributions to Hawaii's physician shortage;
106	106
107	107
108	108
109	109	(2) Analyze "medical management" administrative costs and the administrative cost of payment reforms from payments to providers for provision of health care; and
110	110
111	111
112	112
113	113	(3) Investigate other issues it deems relevant; and
114	114
115	115
116	116
117	117	BE IT FURTHER RESOLVED that the Legislative Reference Bureau is requested to submit a report of its findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2023; and
118	118
119	119
120	120
121	121	BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Director of the Legislative Reference Bureau and Administrator of the Hawaii Employer-Union Health Benefits Trust Fund.
122	122
123	123
124	124
125	125
126	126
127	127
128	128
129	129	OFFERED BY: _____________________________
130	130
131	131
132	132
133	133	OFFERED BY:
134	134
135	135	_____________________________
136	136
137	137	Report Title:
138	138
139	139	Legislative Reference Bureau; Employer-Union Health Benefits Trust Fund; Financial Analysis