Health Care
Ensuring access to quality, affordable health care for all Americans
"I am deeply committed to expanding access to quality, affordable health care services, preserving existing coverage, and slowing the increasing costs of health care.  This mission has always been guided by Hawaii's successful delivery system and the unique needs and challenges that face our islands.  As the landmark health insurance reform law that we enacted in 2010 is implemented, more people will continue to see an improved ability to access the health care services they need."


Senator Akaka has been a longstanding champion of improved health care delivery system nationally, while recognizing the unique challenges and needs of Hawaii.  His work in this area will be centered on building upon an extraordinary accomplishment:  the enactment of the Patient Protection and Affordable Care Act.

Senator Akaka is focused on eliminating health care disparities, particularly with regard to Native Hawaiians, Native Americans, and minority populations.  He is a member of the bipartisan Senate Rural Health Caucus and is a strong supporter of medical research, mental health care services, preventative health care, and health promotion activities.

As a senior member and past Chairman of the Senate Veterans' Affairs Committee and member of the Senate Armed Services Committee, Senator Akaka has had a special interest and strong record in preserving and expanding access to health care for the members of our armed services and their families and the veterans who have honorably served our nation.

Recent Accomplishments and Activities

Health Insurance Reform

In 2010, Congress passed a landmark comprehensive health insurance reform law.  Senator Akaka was a strong supporter of this effort.  In addition, two of Senator Akaka's longtime priorities are included in the new law:  a permanent restoration of Hawaii's Medicaid Disproportionate Share Hospital allotment and a rule of construction to preserve the Hawaii Prepaid Health Care Act.  

The Patient Protection and Affordable Care Act expands access to coverage, improves the quality and availability of health care services, and slows increasing health care costs.  The law also ensures that individuals with preexisting conditions will be able to get insurance and prohibits unfair lifetime limits imposed by health insurance companies.  

The benefits of the new law are already being realized by Hawaii residents:

• Small businesses in Hawaii can receive tax credits for contributions to purchase health insurance for their employees;
• Nearly 18,000 seniors in Hawaii received a one-time, tax-free $250 rebate to help pay for prescription drugs in Medicare's "donut hole" coverage gap;
• 193,000 seniors in Hawaii who have Medicare coverage can stay healthy by getting regular checkups without having to pay a co-pay for annual visits and important preventative services like mammograms and colonoscopies;
• A federal Pre-Existing Condition Plan has been established to provide health insurance to those that have been denied coverage;
• 805,000 Hawaii residents with private health insurance no longer have to worry about lifetime limits being placed on coverage and will be protected from having their health insurance retroactively cancelled;
• Thousands of young adults can stay on their parents' plan after they finish school and while they look for a job, until they turn 26 years old;
• Hawaii businesses are receiving federal assistance through the early retiree reinsurance program to help retirees, employees and their families maintain access to health insurance;
• Insurance companies are prohibited from denying coverage to children on the basis of pre-existing medical conditions; and
• A new appeals process allows beneficiaries to dispute insurance company coverage determinations and claims.

Permanent restoration of funding for hospitals that treat the poor and uninsured

The new health insurance law permanently restores a funding source for hospitals that care for significant numbers of low-income and uninsured patients in Hawaii.  This provision was based on an amendment offered by Senator Akaka that permanently restores a Medicaid Disproportionate Share Hospital (DSH) allotment for the state.

The DSH allotment will provide additional funding to the state of Hawaii to permit a greater contribution toward the uncompensated costs of care incurred by hospitals that treat the uninsured, Medicaid beneficiaries, and the state's underserved communities.  Hawaii's hospitals will receive an estimated $100 million in Medicaid DSH resources over the next ten years alone.  The state of Hawaii will need to provide matching funds to draw down the federal money.

Hawaii lost its Medicaid DSH allotment in 1995.  Beginning with the Tax Relief and Health Care Act of 2006, Senator Akaka had worked tirelessly to secure temporarily DSH allotments for Hawaii in enacted health care legislation.  Senator Akaka included  provisions in the Medicare, Medicaid, and SCHIP Extension Act of 2007, the Medicare Improvements for Patients and Providers Act of 2008, and the CHIP Reauthorization Act of 2009 that provided over $50 million for Hawaii since Fiscal Year 2007.  Senator Akaka's provision in the Patient Protection and Affordable Care Act provides a permanent restoration of the DSH funding for the state of Hawaii when the temporary extensions that he already secured expire.

Protecting Hawaii's unique health care system

The new health insurance law includes a provision secured by Senator Akaka to preserve Hawaii's long-standing system of employer-based health care.  A large percentage of Hawaii residents have health insurance because of the state's unique health care system.

Senator Akaka firmly believes that, as we expand access to health care, we should build upon our existing system of coverage, which has resulted in Hawaii's uninsured rates to be among the lowest in the nation.  Consequently, the new law preserves Hawaii's exemption to the Employee Retirement Income Security Act that ensures the continued effectiveness of the Prepaid Health Care Act, Hawaii's insurance law.

Veterans' Health

New Veterans Benefits Law.  In September 2010, the President signed a key measure authored by Senator Akaka that will expand insurance options for disabled veterans, upgrade compensation benefits and employment protections, authorize VA construction projects, and allow VA to keep using private physicians to quickly and accurately provide veterans with disability evaluations.

Expanding Health Insurance Reform Benefits.  As Chairman of the Senate Committee on Veterans' Affairs, Senator Akaka sponsored a bill (S. 3162) to clarify that the health care VA provides to children with spina bifida born to veterans of the Vietnam War and to some veterans who served in Korea during specified times, as well as to children of women Vietnam veterans with certain birth defects, meets the standard of minimum health care coverage required by the Patient Protection and Affordable Care Act.  This bill was passed unanimously by the Senate on March 26, 2010.

New Veterans Outpatient Clinic Opened in Leeward Oahu.  At the urging of Senator Akaka, the Veterans Administration opened a new outpatient clinic for leeward Oahu residents in 2010.  Senator Akaka had pushed for the new clinic to serve west side veterans who would otherwise travel long distances for simple procedures.  Now, VA clinicians are available in the neighborhood to provide primary care and other health care services, serving a community of approximately 8,000 vets. 

Additional Information

Hawaii Department of Health

Hawaii Department of Human Services

Hawaii Insurance Commissioner

Constituent Services

  • Washington D.C. Office
  • Honolulu Office
  • Hilo Office

United States Senate

141 Hart Senate Office Building

Washington, D.C. 20510

Telephone: (202) 224-6361

Fax: (202) 224-2126


Honolulu Office

300 Ala Moana Blvd., Rm. 3-106

Box 50144

Honolulu, HI 96850

Telephone: (808) 522-8970

Fax: (808) 545-4683


Hilo Office

101 Aupuni Street, Suite 213

Hilo, HI 96720

Telephone: (808) 935-1114

Fax: (808) 935-9064