Hawaii bets right on SCOTUS health care ruling

Associated Press

HONOLULU (AP) — Hawaii bet correctly that the Supreme Court would uphold the bulk of President Barack Obama's health care overhaul, but the state plans a full analysis to see how the lengthy ruling affects plans to implement the law.

The Thursday ruling upheld the law's key provisions — including its hotly-debated requirement that nearly every American carry health insurance — and kept Hawaii largely in line with legislation it supported since its passage.

Hawaii Gov. Neil Abercrombie, a Democrat, said that the politics around the issue won't go away, but the state is keeping its priority of making sure Hawaii residents have a high quality system with sustainable costs.

"The Affordable Care Act is our ally in Hawaii to provide health care for everyone," Abercrombie said Thursday. "We're pioneers in it."

Hawaii Health Care Transformation Coordinator Beth Giesting told The Associated Press earlier this week that state officials thought about different ways justices might rule, but kept moving as if would be upheld.

She admitted Thursday that she wasn't confident in her ability to predict the ruling.

"It was a hope — I actually have to say that I was surprised," Giesting said. "I heard from people who had every possible opinion about how it was going to come out."

The outcome was praised by Hawaii's federal lawmakers — all Democrats — as well as Ed Case, a Democratic former Congressman running against U.S. Rep. Mazie Hirono for their party's nomination for a U.S. Senate seat in play in November.

Linda Lingle, the likely Republican nominee for that seat, said the next Congress must address issues the overhaul ignored and other "questionable policy judgments," but stopped short of calling for a full repeal, as Republicans in other states did Thursday.

According to 2010 U.S. Census data, roughly 97,000 Hawaii residents, or 7.7 percent, are without health insurance — the second-lowest rate in the country behind Massachusetts at 5.5 percent.

Abercrombie credited that rate in part to a state law on the books since 1974 that requires employers to provide health care coverage to employees who work at least 20 hours per week. Employers can only ask each employee to pay up to half their monthly premiums — and only if that amount doesn't exceed 1.5 percent of the worker's gross monthly income.

Pat McManaman, the state's director of human services, said Hawaii could end up with an even lower rate than Massachusetts after the law fully kicks in.

The biggest change for states across the country in the ruling may be in Medicaid. The justices ruled the federal government can expand the program if it doesn't threaten states' entire Medicaid allotment if they don't take part. That means some states looking to cut costs might choose to not expand coverage, with less worry than before.

Hawaii isn't pulling back, McManaman said.

"I think the fact that we're moving forward is signified by the policy changes that will go into effect July 1," she said.

Starting next month, Hawaii's eligibility requirements for Medicaid will be in line with federal guidelines under the overhaul, meaning an additional 24,000 people who weren't previously insured will be newly eligible for Medicaid, McManaman said.

McManaman said 24,000 others are expected to enroll in the program for the first time even though they were previously eligible, and 20,000 will change to Medicaid from other providers.

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Oskar Garcia can be reached on Twitter at http://twitter.com/oskargarcia .

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