We applaud the Honolulu Star-Advertiser’s March 22 editorial, “Raise Payments for Medicaid Care,” which supports both Senate Bill 397 and Senate Bill 1035. Both bills have been advancing in the Hawaii Legislature and now face hearings in the House Finance Committee, the last major hurdle to becoming law. Both the House and Senate should be commended for listening to patients and providers throughout the state who say they need help, now.

SB 397 would enable health-care providers to care for more low-income individuals and families, by making Medicaid reimbursements (called Med-QUEST in Hawaii) on par with Medicare payments. This is a financially viable bill for Hawaii; investments made by the state would bring in additional federal funding to serve the most vulnerable in our community.

With more than half of our keiki and over 465,000 residents in Hawaii on Med-QUEST, we must do everything we can to ensure that they have timely and affordable access to physicians and other healthcare providers. We need the House Finance Committee and the full Legislature to fund the state’s contribution and protect the health of ALL of Hawaii’s citizens, regardless of what insurance they can afford.

SB 1035 is another bill designed to address the health-care shortage by improving access to care for those with Medicaid, TRICARE and Medicare (commonly used among our kupuna). It proposes to do this by extending to private practice health-care providers the same support already given to nonprofit hospitals and their providers, exemption from the general excise tax (GET).

As has often been noted, Hawaii is one of only two states imposing this tax on medical services. Private practice health-care providers, including family medicine and primary care clinics, often serve in more rural and underserved areas of Hawaii where the low population density makes it less practical for larger hospitals and health-care facilities to locate. To provide care, these private practice providers carry major costs in addition to a heavy tax burden. The current version of this bill calls for a temporary GET exemption, giving real world experience to see if it has a positive impact on patient access to care.

The dire situation of the physician shortage in Hawaii is well-documented. It’s especially apparent on our neighbor islands and in rural areas of our state. Recent data quantifies the devastating impact on patients who experience our physician shortage firsthand.

The 2022 Access to Care survey, led by Hawaii Island’s Community First Hawaii (and supported by many community organizations including HMA, HMSA, the Hawaii State Rural Health Association, Hawaii Department of Health and the Hawaii Health Systems Corp.), confirms what many health-care care professionals have been saying: Nearly 6 in 10 (58%) patients say they experienced health-care delays in the past year, with 1 in 5 indicating the wait was significant. Nearly half of providers (48%) report that the wait to see any specialist — whether on or off island — is more than a month and can be longer than two months.

The incredible stress physicians and other health-care providers experience in trying to meet the needs of their patients and community is driving many to consider leaving or retiring from medicine (53%) and even moving to the continent (49%). Hawaii island, for example, is already short 183 physicians with only 37% of the physicians it needs.

We cannot afford to lose any more physicians or other health-care professionals. We need the Legislature to see these bills to the finish during this session. There’s too much at stake.

Angela M. Pratt, M.D., Thomas S. Kosasa, M.D., and Elizabeth Ann Ignacio, M.D., are physicians in Hawaii.