Governor Josh Green must address the proposed consolidation between Hawaiʻi Pacific Health and HMSA, which could exacerbate the existing issues of limited healthcare access in the state. The current healthcare system in Maui, a high-cost state with low reimbursement rates, is already strained by supply restrictions and consolidation. This has led to long wait times for critical services, such as dialysis and cancer biopsies, and patients being forced to travel off-island for care that should be available locally. The root causes of these problems are Certificate of Need laws, hospital and insurer consolidation, and a two-tier healthcare system that prioritizes profit over patient care. The proposed integration would further concentrate pricing power, reduce transparency, and harm independent providers. The human toll of these issues is real and growing, affecting health, families, and livelihoods. The governor has the authority to take action, including imposing enforceable guardrails on healthcare consolidation, opening the insurance market to competition, ending 'paper capacity' by requiring approved projects to be built, enforcing network adequacy laws, and pursuing a higher Medicare Geographic Practice Cost Index to support physicians in Hawaiʻi. This is not just about healthcare; it's about the survival of families, private practitioners, tradespeople, and small businesses, as well as the sovereignty of the state from concentrated control over daily life and means of livelihood.
