STAND. COM. REP. NO. 2469

Honolulu, Hawaii

RE: S.B. No. 2634

S.D. 1

Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2022

State of Hawaii

Sir:

Your Committees on Human Services and Health, to which was referred S.B. No. 2634 entitled:

"A BILL FOR AN ACT RELATING TO HEALTH,"

beg leave to report as follows:

The purpose and intent of this measure is to appropriate funds to extend Medicaid postpartum coverage from sixty days to twelve months.

Your Committees received testimony in support of this measure from the Department of Human Services; Executive Office on Early Learning; Hawai‘i State Commission on the Status of Women; AlohaCare; Hawai‘i Public Health Institute Obesity Prevention Task Force; Save Medicaid Hawaii; American College of Obstetricians and Gynecologists Hawai‘i Section; Healthcare Association of Hawaii; American Heart Association; Hawaii Association of Health Plans; Hawaii Primary Care Association; Hawaii Women's Coalition; Hawaii Medical Service Association; Kokua Kalihi Valley Comprehensive Family Services; American Academy of Pediatrics, Hawaii Chapter; Planned Parenthood Alliance Advocates--Hawai‘i; Hawai‘i Children's Action Network Speaks!; Hawai‘i Women Lawyers; Early Childhood Action Strategy; Hawaii Medical Association; Hawai‘i Association of School Psychologists; Hawaii Family Forum; Hawai‘i Public Health Association; Hawai‘i Pacific Health; Mental Health America of Hawai‘i; Hawai‘i Maternal & Infant Health Collaborative; Kaiser Permanente Hawai‘i; Association for Infant Mental Health Hawai‘i; ‘Ahahui o Nā Kauka--Association of Native Hawaiian Physicians; Healthy Mothers Healthy Babies Coalition of Hawaii; Hawaii Health & Harm Reduction Center; and twenty-eight individuals. Your Committees received comments on this measure from the Department of Budget and Finance.

Your Committees find that the "pregnant women" Medicaid eligibility category is currently limited to sixty days postpartum. Despite this limited window of coverage, there are many conditions that account for significant risks far beyond sixty days including cardiovascular disease, hypertension, depression, and other pregnancy-related morbidities that require care over a longer term. The American Rescue Plan Act of 2021 provides an option to extend Medicaid postpartum coverage an additional ten months via state plans, beginning April 1, 2022, and is in effect for five years. Extending postpartum coverage to twelve months will help address the stark health disparities many native Hawaiian and Pacific Islander mothers experience and will greatly improve health access and outcomes for women and children in the State by providing continuity of care with known and trusted providers during this high-risk period.

Your Committees have reviewed the testimony of the Department of Budget and Finance expressing concerns regarding this measure's possible effect on the State's obligation to adhere to the maintenance of effort requirements as a recipient of Elementary and Secondary Schools Emergency Relief funds under the Coronavirus Response and Relief Supplemental Appropriations Act of 2021 and the American Recovery Plan Act of 2021. Your Committees find that this issue raises concerns that merit further consideration and respectfully requests that your Committee on Ways and Means further examine the issues and concerns raised by the testimony.

Your Committees have amended this measure by:

(1) Inserting an effective date of December 31, 2050, to encourage further discussion; and

(2) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

As affirmed by the records of votes of the members of your Committees on Human Services and Health that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 2634, as amended herein, and recommend that it pass Second Reading in the form attached hereto as S.B. No. 2634, S.D. 1, and be referred to your Committee on Ways and Means.

Respectfully submitted on behalf of the members of the Committees on Human Services and Health,

________________________________ JARRETT KEOHOKALOLE, Chair

________________________________ JOY A. SAN BUENAVENTURA, Chair