SCR 97: requesting the auditor to assess the social and financial effects of mandating health insurance coverage for ambulance and COMMUNITY PARAMEDICINE SERVICES.

SENATE CONCURRENT

RESOLUTION

requesting the auditor to assess the social and financial effects of mandating health insurance coverage for ambulance and COMMUNITY PARAMEDICINE SERVICES.

     WHEREAS, a substantial number of transfers to a hospital provided by an emergency medical services ambulatory service are for health conditions that are not considered to be an emergency, which can result not only in wasted health care resources but can also potentially prevent the delivery of life‑saving services to other individuals who may truly be experiencing a life-threatening emergency; and

     WHEREAS, community paramedicine is a model of community‑based health care in which paramedics function outside their customary emergency response and transport roles in ways that facilitate more appropriate use of emergency care resources; and

     WHEREAS, an important advantage of community paramedicine is the ability to treat patients at home without transport to a hospital or clinic, which enhances access to primary care and support services, especially for medically underserved areas; and

     WHEREAS, community paramedicine services can also improve access to preventative care, help triage patients, and alleviate the overburdened hospital and emergency departments, which in turn can help decrease health care costs; and

     WHEREAS, reimbursement for community paramedicine services is essential to the Community Paramedicine Program's sustainability; and

     WHEREAS, pursuant to section 23-51, Hawaii Revised Statutes, before any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, concurrent resolutions shall be passed that designate a specific legislative bill for the Auditor to review and prepare a report for submission to the Legislature that assesses both the social and financial effects of the proposed mandated coverage under that legislative bill; now, therefore,

     BE IT RESOLVED by the Senate of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2025, the House of Representatives concurring, that the Auditor is requested to assess both the social and financial effects of the proposed mandated health insurance coverage under S.B. No. 783, introduced in the Regular Session of 2025, that:

     (1)  Requires Medicaid and private insurance coverage of ambulance services; and

     (2)  Authorizes Medicaid programs, and requires private insurers, to cover community paramedicine services rendered statewide by emergency medical technicians or paramedics; and

     BE IT FURTHER RESOLVED that the Auditor is further requested to include in its assessment the impact of section 1311(d)(3) of the federal Patient Protection and Affordable Care Act (PPACA) on Senate Bill No. 783, or similar legislation, that includes but is not limited to the additional cost of any benefits beyond the essential health benefits of Hawaii's qualified health plans under the PPACA; and

     BE IT FURTHER RESOLVED that the Auditor is also requested to determine how many qualified health plans are available in the State, including plans offered by health maintenance organizations; the individual or group enrollment in these plans; and the actuarial cost of the defrayment to the State for ambulance services and community paramedicine services; and

     BE IT FURTHER RESOLVED that the Auditor is requested to submit a report on the Auditor's findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2026; and

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor and Insurance Commissioner, who is requested to transmit copies to each insurer in the State that issues health insurance policies.

Report Title: 

Auditor; Impact Assessment Report; Mandatory Health Insurance Coverage; Ambulance Services; Community Paramedicine Services