The Obamacare mandate that forces large companies to offer employee health insurance is nothing new for Hawaii, which has had a stricter requirement on its books for nearly 40 years.
Supporters of the Hawaii employer mandate say the country can adjust to the Obamacare provision just as Hawaiians have come to accept the state law as necessary cost of doing business.
According to Politico
, all Hawaiian companies, regardless of size, must offer insurance coverage to employees working more than 19 hours a week.
The Obamacare requirement is for companies with at least 50 employees, and then applies only to those working at least 30 hours a week. Insurance provided under the Obamacare mandate must cost no more than 9.5 percent of an employee's income. In Hawaii, it cannot cost more than 1.5 percent of a worker's income.
Companies in Hawaii that do not offer enough insurance coverage can be fined or have various business permits put on hold.
"For the most part, the business owners here want to take care of their employees. They’ve embraced [the law]," said Brian Fitzgerald, a spokesman for the Hawaii Health Connector, the state health insurance exchange that will expand its marketplace to offer more coverage plans under Obamacare.
According to Politico, that's also been true in Massachusetts, which has its own healthcare law but with a less-strict employer mandate and also an individual mandate.
Overall, the Affordable Care Act is not expected to affect Hawaii's businesses because they already operate under tougher insurance requirements.
"The key is to know that if you are meeting the requirements of the Hawaii Prepaid Health Care Act, you're likely already in compliance with the Affordable Care Act," Antonio Saguibo Jr., vice president of account management and sales at HMSA/Blue Cross Blue Shield of Hawaii, told TheGardenIsland.com.
State law already has advanced Hawaii to a place "largely in front of the wave" likely to be created by the Obamacare rollout beginning Oct. 1, he said.
Republican efforts to repeal the 1974 state law have been unsuccessful, state Senate Minority Leader Sam Slom told Politico.
"I hardly get any support for them either inside the legislature or outside of it," he said, noting that businesses are less concerned about the coverage requirements than they are about keeping state-specific benefits that are more generous than those provided through Obamacare.
Democratic state Sen. Josh Green, a physician who chairs the Senate Health Committee, said the state's employer mandate has become an accepted part of Hawaiian law and that most people take it for granted.
But he worries that Obamacare still could have a tough time taking hold in the state, primarily because most of Hawaii's 90,000 uninsured people are young and healthy and unlikely to buy insurance, even though they would face fines.
"I think that many of these individuals will not see becoming insured as a benefit that outweighs the penalties, and therefore will not engage," he said. "As a physician, I would have preferred an approach that focused more on access to services rather than access to coverage, which will be of minimal benefit if there aren’t more doctors and nurses to care for patients."
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