for All Milestones
Lack of health coverage is an issue
that has been pushed to the forefront by many caring and concerned
Hawaii State Department of Health brought community leadership
around the issue of Hawaii’s growing number of medically
uninsured. While leadership from all sectors of the community
agreed that the
problem needed to be addressed, there was no single organization
to adopt and champion the issue.
HMSA Foundation, the philanthropic arm of HMSA, stepped forward
and made a three-year commitment to study and address the growing
of Hawaii’s people without health coverage, and The Hawai`i
Uninsured Project was born.
Recognizing the importance of an open and inclusive process, a nine-month
community-wide planning initiative led to a statewide “Leadership
Assembly” in November 2000. Conference findings provided a
starting point to initiate research and begin to draw a picture of
A year of analysis followed, along with gathering community suggestions
on addressing the complex problems of the uninsured. In November
2001, the Policy Summit – Ways to Insure the Uninsured – helped
to identify strategies with the greatest potential for coverage expansion.
areas of focus emerged:
- employment-based insurance
- government-based insurance
- the safety net
Many months of intensive analysis led to further refinement of
coverage options. These insights were recorded and presented to
of experts in a Coverage for All Design Forum held on May 30,
2002. This group collectively generated what is believed to be the best
set of target areas for expansion.
- the working but uninsured
- strengthening the safety net
- categorically eligible adults and enrollment barriers
- Hawaii’s children
- Uninsured citizens of the ‘compact’ states
It was also
decided that research and community discussion around the Prepaid
Health Care Act was needed.
A statewide education and community-listening
campaign was conducted that included presentations and informational
To fund the research and the process of developing
community-based solutions, federal and national grants were pursued
HMSA Foundation and community collaborators including the
Health and the non-partisan, non-profit Hawaii Institute
for Public Affairs
so that The Hawai`i Uninsured Project could begin operating
in complete independence from HMSA Foundation.
More than $2 million in grants were awarded from The Robert
Wood Johnson Foundation and the U.S. Department of Health & Human
The Hawai`i Uninsured Project formed a
broad-based community coalition, established in each of
the target areas for expansion.
Over the course of a year, these volunteer community work
groups discussed the issues and proposed policy scenarios
to the Social
Science Research Institute to explore potential impact
of coverage. The Hawaii Health Information Corporation
spearheaded the effort
to acquire and access the necessary private and public
The Social Science Research Institute conducted about 250 statewide
interviews with the uninsured and their
health centers across the state to build a better knowledge
of their issues and their ideas on solutions. In addition,
a socio-demographic profile of the uninsured based on existing
surveys and data.
The Hawai`i Uninsured Project also
set out on a fact-finding mission to learn more about current
viewpoints in the marketplace
today through statewide telephone surveys and focus groups:
employers, part-time workers, self-employed and the general
On October 29, 2003, key findings from these research
efforts were shared with Hawaii’s leadership for the community’s
response, input and dialogue.