With its sugar-sand beaches, stunning volcanoes and warm tropical climate, the Aloha State’s economy is largely supported by tourism. Hawaii is the only state located in Oceania and is sometimes referred to as “the most liberal state in the country.” Its four congressional seats are dominated by Democrats, and Hawaiian voters have supported Democratic presidential candidates almost 87 percent of the time. In 1974, the state enacted the Hawaii Prepaid Health Care Act, making it the first state to improve coverage for health care through a state mandate.
Enrollment through the Years
Hawaii utilizes the federal marketplace for enrollment in Obamacare plans. The state has seen a relatively steady increase in ACA enrollment since 2015.
- 12,625 enrolled in 2015
- 14,564 enrolled in 2016
- 19,145 enrolled in 2017
In 2017, there were 6,830 new Obamacare enrollees, with 12,108 remaining from the previous year. People between the ages of 55-64 were the most enrolled demographic. Hawaii remains largely supportive of the Affordable Care Act and opted to expand Medicaid to cover more individuals and families.
As of 2014, any qualified resident or citizen under the age of 65 with income under 138 percent of the federal poverty level is eligible for Medicaid in Hawaii regardless of his or her assets. Expansion in the state opened up the program to 115,400 new enrollees.
Hawaii’s insurance marketplace allows individuals and families to compare their choices when signing up for health insurance. Some people may qualify for cost assistance or tax credits depending on their income or family size. Tax credits are typically available for those with an annual household income between 100 and 400 percent of the federal poverty level. It’s important to note that Hawaii’s FPL is different from that of Alaska and the contiguous 48 states.
In 2017, 80 percent of marketplace enrollees received tax credits to pay for premiums while 58 percent qualified for additional cost-sharing reduction payments. These CSRs are available to people earning up to 250 percent of the FPL.
Carrier Participation & Plan Availability
Two carriers currently offer plans in the Hawaii healthcare marketplace and offer both individual and family plans – 92 in all. Both insurers have filed plans to participate in the 2018 exchange, but rate changes have not been made public. Because of the uncertainty surrounding the future of the ACA, Hawaii enacted a working group that seeks to preserve its consumer protections.