Dive Brief:
- Hawaii has published its draft proposal to waive certain provisions of the ACA.
- The waivers seek to eliminate the ACA provisions that would “diminish” the Hawaii Prepaid Health Care Act, which went into effect in 1974.
- Pacific Business News reports due to Hawaii employer’s 85% cost share, the state's uninsured rate is among one of the lowest in the U.S. at 5.3%.
Dive Insight:
The proposal states Hawaii seeks to maintain all aspects of the Hawaii Prepaid Health Care Act. Under the law, employees cannot be charged more than 1.5% of their wages for premiums, compared to ACA’s potential 2%-9.5%, Pacific Business News reports.
“The Prepaid model manages the richness of benefits by identifying the prevalent PPO and HMO benefit packages in the state and making those packages the floor for benefit coverage,” the draft proposal states. “As a result, the benefit plans sold to employers in the state have an average actuarial value of 90%.”
One example of waiver requests is the state is seeking to waive the Small Business Health Options Program (SHOP) in 2017. Pacific Business News reports while the proposal does not back up claims with a 10-year budget, it says the SHOP removal will save the federal government money.
The proposal remarks Hawaii shares the goals of the ACA but its Prepaid Act, “both simpler and more sweeping than the ACA, has shaped Hawaii’s health insurance landscape in numerous positive ways.”
The specific provisions Hawaii is seeking to waive in the ACA are Sections 1301, 1304, 1311 and 1312.