Health Care in Hawaii:

Implications for National Reform

HEHS-94-68: Published: Feb 11, 1994. Publicly Released: Mar 15, 1994.

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Pursuant to a congressional request, GAO provided information on Hawaii's health care insurance system, focusing on the system's effect on: (1) accessibility to health services; (2) health care costs; and (3) the business community.

GAO found that: (1) Hawaii has the highest level of insurance coverage of any state in the United States; (2) the percentage of Hawaiian residents that lack health insurance ranges from 3.75 to 7.0 percent, as compared to the national average of 14 percent; (3) Hawaii's employer mandate does not ensure health insurance for all residents; (4) some insured Hawaiian residents have encountered problems obtaining health services due to private providers' unwillingness to serve Medicaid patients; (5) Hawaii's per capita health care expenditures are similar to other states; (6) Hawaii's health insurance premiums are generally lower and have risen at a slower rate than that of other states due to reduced cost shifting and insurance companies' use of modified community rating for small businesses; (7) Hawaii's small business sector has not been adversely affected by the mandated requirement that employers provide health insurance; (8) business owners have expressed concern regarding the cost and inflexibility of the employer mandate; and (9) health care providers are generally satisfied with Hawaii's health care system because widespread insurance coverage has decreased the amount of uncompensated medical care.

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