219
HOUSE OF REPRESENTATIVES             H.C.R. NO.            
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                     HOUSE  CONCURRENT
                        RESOLUTION

  URGING THE UNITED STATES CONGRESS, THE PRESIDENT OF THE UNITED
    STATES, AND THE SECRETARY OF HEALTH AND HUMAN SERVICES TO
    SUPPORT THE HAWAII CONGRESSIONAL DELEGATION'S EFFORT TO
    AMEND THE SOCIAL SECURITY ACT TO INCREASE HAWAII'S FEDERAL
    MEDICAL ASSISTANCE PERCENTAGE (FMAP).



 1        WHEREAS, the State of Alaska received an increase in its
 2   Federal Medical Assistance Percentage (FMAP) from 50 percent to
 3   59.8 percent in consideration of the high cost of living in
 4   Alaska by an amendment to the Social Security Act; and
 5   
 6        WHEREAS, United States Senator Daniel K. Akaka, United
 7   States Senator Daniel K. Inouye, United States Representative
 8   Neil Abercrombie, and United States Representative Patsy T.
 9   Mink have recently introduced federal legislation to amend the
10   Social Security Act to increase Hawaii's FMAP in consideration
11   of Hawaii's high cost of living; and
12   
13        WHEREAS, federal financial participation for the medicaid
14   program is based on the FMAP which is calculated according to a
15   formula based on per capita income in the individual state in
16   relation to the per capita income of the United States; and
17   
18        WHEREAS, the FMAP is calculated as the quotient of the per
19   capita income of the United States, times a multiplier, the
20   state income is determined as a designated portion of the
21   national income as determined at the United States Department
22   of Commerce, Bureau of Economic Analysis (BEA) and the per
23   capita income of Hawaii is an amount that is derived at the BEA
24   as a portion of national income statistics; and
25   
26        WHEREAS, because of its island location and other factors,
27   the cost of living in Hawaii greatly exceeds the cost of living
28   in the mainland states, so that per capita income is a poor
29   measure of its relative ability to bear the cost of medicaid
30   services; and
31   

 
a                                                     HMS-RI(99)
Page 2                                                     219
                                  H.C.R. NO.            
                                                        
                                                        

 
 1        WHEREAS, a study conducted by the Taubman Center for State
 2   and Local Government at Harvard University's John F. Kennedy
 3   School of Government and the Office of United States Senator
 4   Daniel Patrick Moynihan, established that if per capita income
 5   is measured in real terms, considering cost of living factors,
 6   Hawaii ranked 47th at $19,755 compared to the national average
 7   $24,231 and Alaska is ranked 34th with a real per capita income
 8   level of $21,592; and
 9   
10        WHEREAS, the Harvard/Moynihan study cites Hawaii with one
11   of the highest poverty rates in the nation--Hawaii ranks eighth
12   in the country with a poverty rate of 16.9 percent as compared
13   to the national average of 14.7 percent--and on a per capita
14   basis state revenues and expenditures are far higher in Hawaii,
15   as well as Alaska, than in the other 48 mainland states, but
16   Alaska's 10.6 percent poverty rate is lower than the national
17   average, placing it 39th in the country; and
18   
19        WHEREAS, Hawaii has not participated in the economic
20   rebound that has benefited most of the rest of the nation in
21   the past several years, in part because of its heavy dependence
22   on international tourism and trade, and Hawaii continues to
23   suffer from the drop in value in the Japanese yen, its
24   unemployment rate is above the national average, and its tax
25   revenues have fallen short of estimates; and
26   
27        WHEREAS, based on Hawaii's current medicaid spending level
28   of approximately $700 million, each percentage point increase
29   in its FMAP rate would provide approximately $7 million
30   annually in additional federal funds; and
31   
32        WHEREAS, the State of Hawaii is seeking to have its
33   medicaid program funded in dollars equal to its tax
34   contributions based on its higher per capita income and one
35   that recognizes its true costs, as was done for Alaska; now,
36   therefore,
37   
38        BE IT RESOLVED by the House of Representatives of the
39   Twentieth Legislature of the State of Hawaii, Regular Session
40   of 1999, the Senate concurring, that this body hereby urges the
41   United States Congress, the President of the United States, and
42   the United States Secretary of Health and Human Services to
43   support United States Senator Daniel K. Akaka, United States
44   Senator Daniel K. Inouye, United States Representative Neil
45   Abercrombie, and United States Representative Patsy T. Mink's
46   federal legislation to amend the Social Security Act to

 
a                                                     HMS-RI(99)
Page 3                                                     219
                                  H.C.R. NO.            
                                                        
                                                        

 
 1   increase Hawaii's FMAP in consideration of our high cost of
 2   living; and
 3   
 4        BE IT FURTHER RESOLVED that certified copies of the
 5   Concurrent Resolution be transmitted to the members of the
 6   United States Congress, the President of the United States, and
 7   the Secretary of the United States Department of Health and
 8   Human Services.
 9 
10 
11 
12                           OFFERED BY: ___________________________
13 

 
a                                                     HMS-RI(99)