SB714

THE SENATE	S.B. NO.	714
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

A BILL FOR AN ACT

RELATING TO MEDICAID.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that access to quality health care that is accessible, affordable, and equitable is of paramount importance to public health and wellness. The legislature finds however, that presently, approximately five hundred pregnant persons and four thousand income-qualified children in the state are denied access to affordable health care through medicaid, the children's health insurance program, and health insurance exchanges established under the Patient Protection and Affordable Care Act, Public Law 111-148, solely due to their immigration status. Furthermore, evidence-based studies determined that low-income immigrants without prenatal care are seven times more likely to give birth prematurely and five times more likely to experience neonatal death, demonstrating that limited access to health care for pregnant persons and their newborn children significantly increases risk of exposure to life-threatening situations.

The legislature further finds that as of 2024, twenty-two states plus the District of Columbia provide medicaid coverage to all income-qualified pregnant residents regardless of their immigrant status. For Hawaii, with the current cost of an average neonatal intensive care unit stay being between $7,000 and $8,000 per day, the department of human services estimates the cost of providing income-qualified pregnant persons with health insurance coverage and twelve months of post-partum care at $1,364,000 annually. Providing greater access to health insurance coverage for income-qualified pregnant persons will help lower barriers and increase access to health care for resident immigrant populations in the State.

Similarly, low-income immigrant children without access to health care services experience a higher rate of preventable hospitalizations during childhood. Without appropriate medical management, chronic conditions such as asthma and diabetes may lead to life-threatening medical emergencies. Additionally, inadequate access to preventative care such as immunizations and well-being and well-child visits may aggravate various health conditions increasing the occurrence of acute and chronic conditions and can leave developmental health conditions undiagnosed and untreated.

The legislature also finds that as of 2024, twelve states and the District of Columbia provide medicaid coverage to income-eligible children regardless of immigration status. As for Hawaii, the department of human services estimates the cost of providing income-qualified children with health insurance coverage under the federal health services initiative program at $2,976,000, with a wholly funded state program estimated at $9,600,000. Increasing access to health insurance coverage for income-qualified children will improve health care outcomes for all keiki, regardless of immigration status.

Accordingly, the purpose of this Act is to appropriate funds to the department of human services to provide medicaid coverage under the children's health insurance program for income-qualified pregnant persons and children who are otherwise ineligible due to their immigration status.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 to provide medicaid coverage through the children's health insurance program for income-qualified pregnant persons who are otherwise ineligible due to their immigration status.

The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2025-2026 and the same sum or so much thereof as may be necessary for fiscal year 2026-2027 to provide medicaid coverage through the children's health insurance program for income-qualified children who are otherwise ineligible due to their immigration status.

The sums appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2025.

INTRODUCED BY:	_____________________________

Report Title:

DHS; Medicaid; Children's Health Insurance Program; Pregnant Persons; Children; Immigration Status; Appropriations

Description:

Appropriates funds to the Department of Human Services to provide Medicaid coverage under the Children's Health Insurance Program for income-qualified pregnant persons and children who are otherwise ineligible due to their immigration status.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

SB 714: RELATING TO MEDICAID.

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