Health Insurance: The Hawaii Experience Page: 3
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FOREWORD
Reform of the Nation's health insurance system is at or near the top of the
Nation's domestic policy agenda. As policy makers consider the many directions
the Nation could take, they often look to the States as laboratories.
This Background Paper provides a detailed look at the State that is often
considered a model for what States can do to help provide universal or near-
universal health insurance coverage for their residents. The Background Paper
discusses the history of health insurance provision in Hawaii, emphasizing two
relatively recent State insurance laws: 1 ) the 1974 law that required employers to
offer coverage to most of their employees, and 2) the 1989 law that provided a
State subsidy for coverage of those individuals who fell in the gap between
employment-based coverage and Medicaid coverage. The paper addresses the
difficulties faced in evaluating the impact of Hawaii's various attempts to provide
coverage and access, and speaks to whether all or parts of Hawaii's experience
can be transferred to other States or to the Nation as a whole.
This paper was prepared as background for OTA's assessment Technology,
Insurance, and the Health Care system. The assessment as a whole was
requested by the Senate Committee on Labor and Human Resources (Edward M.
Kennedy, Chairman), the House Committee on Energy and Commerce (John D.
Dingell, Chairman), the House Committee on Ways and Means Subcommittee on
Health (Willis D. Gradison, then Ranking Minority Member), and Senator Charles E.
Grassley (Committees on Budget, Finance, Special Committee on Aging).
This background paper was prepared under contract to OTA by Lawrence
Miike, M. D., J. D., Professor of Medical Policy at the John A. Burns School of
Medicine, University of Hawaii at Manoa. It was reviewed by an advisory panel,
chaired by James L. Hunt, University Distinguished Professor, University of
Tennessee-Memphis, and by other distinguished individuals. OTA gratefully
acknowledges the contribution of each of these individuals.
(7$-
R GER HERDMAN
Director
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United States. Congress. Office of Technology Assessment. Health Insurance: The Hawaii Experience, report, June 1993; [Washington D.C.]. (https://digital.library.unt.edu/ark:/67531/metadc39707/m1/3/: accessed April 24, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.