STAND. COM. REP. NO. 3036

Honolulu, Hawaii

RE: S.C.R. No. 10

Honorable Ronald D. Kouchi

President of the Senate

Thirtieth State Legislature

Regular Session of 2020

State of Hawaii

Sir:

Your Committee on Human Services, to which was referred S.C.R. No. 10 entitled:

"SENATE CONCURRENT RESOLUTION REQUESTING THAT THE DEPARTMENT OF HUMAN SERVICES PROVIDE AN ESTIMATE OF THE BUDGET APPROPRIATION AND LEGISLATIVE ACTION NECESSARY TO FUND AN EXPANSION OF MED-QUEST COVERAGE TO ALL POST-PARTUM WOMEN FOR A PERIOD OF TWELVE MONTHS FOLLOWING CHILDBIRTH,"

begs leave to report as follows:

The purpose and intent of this measure is to urge the Department of Human Services to provide a budget estimate and a discussion on how the expansion of Med-Quest coverage could be accomplished through legislative and regulatory means to expand the period of coverage for post-partum women.

Your Committee received testimony in support of this measure from the Hawaii Primary Care Association, Save Medicaid Hawaii, Filipina Advocacy Network, Hawaii Women's Coalition, Hawai‘i Appleseed Center for Law and Economic Justice, American Association of University Women of Hawaii, American College of Obstetricians and Gynecologists, Planned Parenthood Votes Northwest and Hawaii, Kōkua Kalihi Valley Comprehensive Family Services, Breastfeeding Hawaii, Hawaii Substance Abuse Coalition, Hawaii Maternal and Infant Health Collaborative, and nine individuals. Your Committee received comments on this measure from the Department of Human Services.

Your Committee finds that women are highly motivated during pregnancy to address their healthcare problems, and that progress in their health can be pre-empted when insurance coverage is lost. Your Committee also finds that in Hawaii, migrant and immigrant groups, populations primarily dependent on Med-Quest, are at high risk of poor birth outcomes and increased neonatal intensive care unit admissions due, in part, to daunting system barriers to continuous health insurance coverage. Medicaid pregnancy coverage, which pays for nearly half of all births in the United States, expires sixty days post-partum. Complications associated with pregnancy do not always end when the pregnancy ends or even sixty days after pregnancy ends.

Your Committee notes, national data and local experience indicates that by extending Med-Quest coverage until twelve months postpartum, incidents of pregnancy-related chronic illnesses, post-partum maternal mortality rates, and costs resulting from improved birth outcomes and fewer neonatal intensive care unit admissions could decrease. Your Committee also notes that extending Med-Quest coverage to twelve months after pregnancy would promote equitable access to healthcare for some of Hawaii's most vulnerable communities.

Your Committee has heard the testimony of the Department of Human Services expressing that there are measures with similar intent that have recently been introduced as well as concern for the potential challenges that may exist in getting federal matching dollars for this program. Your Committee appreciates that the Department will provide a range of well-researched options to consider when refining the proposed coverage expansion for future legislative sessions.

As affirmed by the record of votes of the members of your Committee on Human Services that is attached to this report, your Committee concurs with the intent and purpose of S.C.R. No. 10 and recommends its adoption.

Respectfully submitted on behalf of the members of the Committee on Human Services,

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RUSSELL E. RUDERMAN, Chair