As part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses is available through state and federal health insurance exchanges. Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. premium tax credits) will only be available for coverage purchased via public health insurance exchanges.
All states have three options for setting up a state health insurance exchange:
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Enter into a State-Federal Partnership Exchange
- Create a state-based exchange
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Default to a Federally-Facilitated Exchange
Hawaii uses the federal Health Insurance Marketplace, HealthCare.gov.
Hawaii health insurance exchange - What is it?
The Hawaii health insurance exchange is an online health insurance marketplace through HealthCare.gov. This is where individuals and small businesses shop and compare health insurance choices, and take advantage of healthcare reform tax credits and subsidies.
Individuals seeking health coverage through the Hawaii health insurance exchange will find out if they are eligible for the following tax credits and subsidies:
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Tax credits: Tax credits are available to lower the cost of health coverage for individuals and families who meet income requirements and do not have health insurance from an employer or a government program. The tax credits will be immediately applied to the individual's insurance premium, reducing the amount they pay each month. Individuals and families who make between 138% and 400% of the federal poverty level may be eligible for the tax credit.
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Cost-sharing subsidies: Cost-sharing subsidies will reduce the amount of out-of-pocket health care expenses an individual or family has to pay. These expenses may include the co-payments for health care services or other costs.
Hawaii's small business exchange ("SHOP") will be available for small businesses with 100 or fewer full-time employees.
Hawaii Health Insurance Exchange - How was it Formed?
On July 11, 2011, Governor Neil Abercrombie signed SB 1348 into law establishing the Hawaii Health Insurance Exchange. The law builds on Hawaii’s Prepaid Health Care Act of 1975 (PHCA) which required nearly all employers to provide health insurance to employees working 20 or more hours a week for four consecutive weeks. The legislation established the Exchange as a non-profit corporation. On January 3, 2013, Hawaii received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a state-based exchange.
Hawaii defaulted back to the Federal Health Insurance Marketplace.
Hawaii Health Insurance Exchange - Role of Navigators
Navigators, as required by ACA, will be available across Hawaii to assist individuals and small businesses “navigate” the decision-making process required to purchase health insurance or seek qualification for Medicaid. They will also assist individuals who need help accessing the website. Special outreach will be made to Native Hawaiian communities. Final details about Hawaii's Navigator program have not been released at the time of writing.
