U.S. Sen. Brian Schatz, alongside Hawaii’s congressional delegation, on Thursday introduced legislation seeking higher Medicare reimbursements for the state’s health care providers.
The Protecting Access To Care in Hawaii Act — or PATCH Act — seeks a 24% increase, which would bring it in line with what Alaska gets, according to Schatz. He said it is key to helping the state retain and recruit doctors for a growing number of seniors.
The timing is more urgent than ever, he added, as Hawaii faces an increasingly acute provider shortage, especially on neighbor islands.
“As more people reach Medicare age in Hawaii, we are seeing fewer health care providers because of the rising operating and living costs in our state,” said Schatz. “Our bill would help fix that, boosting Medicare payments to providers and protecting health care access for the 300,000 seniors in Hawaii that rely on Medicare.”
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It is also a matter of fairness, according to Schatz.
Currently, Medicare physician payments per beneficiary in Hawaii are the lowest in the U.S, and reimbursement rates do not factor in Hawaii’s higher health care operating costs due to its geographic isolation.
The bill would revise a “work geographic index” to reflect those higher costs, and is basically seeking the same level of reimbursements as Alaska.
“In lots of other areas of federal reimbursement, there’s a recognition that Hawaii and Alaska are in a category of their own as it relates to costs that would better reflect our reality,” said Schatz.
U.S. Rep. Jill Tokuda, who introduced the companion House bill, said Hawaii consistently ranks among the healthiest states in the U.S., yet remains one of the worst states in which to practice medicine because of lower compensation and higher operating costs.
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“Especially on our Neighbor Islands, this is exacerbating the access to the health care crisis that exists, often making it difficult to recruit and retain physicians and to get patients the timely quality care they need,” Tokuda said in a statement. “My legislation would ensure Medicare reimbursements more accurately reflect the real cost to provide care in Hawaii so that we can keep more local doctors and attract new physicians to the state.”
U.S. Sen. Mazie Hirono said the low physician reimbursements in Hawaii add another obstacle to accessing and providing health care.
“I’m proud to support this legislation to help ensure that our physicians — and other health professionals — are being fairly compensated, while also expanding access to health care across the state,” she said.
U.S. Rep. Ed Case said medical practitioners have struggled for years to provide quality care while dealing with the mounting cost of doing business in Hawaii.
“This bill will help our health care providers focus on providing care through Medicare and spend less time worrying about inadequate reimbursement,” he said.
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Earlier this year, Sens. Schatz and Hirono also introduced a bill alongside their Alaska colleagues, seeking higher Medicare reimbursements for outpatient care from hospitals, including emergency room visits, for enrolled seniors in the two states.
In 2021, they also sought to boost Medicare reimbursements for nursing homes in Hawaii and Alaska through the bipartisan Equitable Payments for Nursing Facilities Act.
Those bills are still pending.
Hawaii has a shortage of about 800 full-time physicians, according to the University of Hawaii John A. Burns School of Medicine.
Other efforts to address the doctor shortage include an educational loan reimbursement program for health care workers that commit to two years of service in Hawaii. The state Legislature also passed a bill this year exempting private health care providers from general excise taxes for services to patients with Medicaid, Medicare and TRICARE.
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“Everything costs more in Hawaii,” said Schatz, “and so the federal reimbursement has to reflect that, and that should go for nursing home care and Medicare services in clinics. We just have to be on an equal footing. Otherwise, we will have Medicare but really Medicare in name only because Medicare without providers is really nothing.”
At UH Hilo, ʻōlelo Hawaiʻi is not simply a subject taught in classrooms, it is a living language that connects us to this place, to one another, and to the generations who came before us.
This column is by Pelehonuamea Harman, director of Native Hawaiian engagement at the University of Hawaiʻi at Hilo. In her columns, Pele shares Native Hawaiian protocols on the use of ōlelo Hawaiʻi (Hawaiian language), cultural traditions, traditional ways of Indigenous learning, and more. This column is on Mahina ʻOlelo Hawaiʻi (Hawaiian Language Month), celebrated every February to honor the Hawaiian language.Pelehonuamea Harman
Each year, the month of Pepeluali marks Mahina ʻŌlelo Hawaiʻi, a time dedicated to celebrating and uplifting the Hawaiian language. At the University of Hawaiʻi at Hilo, ʻōlelo Hawaiʻi is not simply a subject taught in classrooms, it is a living language that connects us to this place, to one another, and to the generations who came before us.
While Pepeluali gives us a focused moment of celebration, the Hawaiian language should not live only within a single month. ʻŌlelo Hawaiʻi thrives when it is used every day.
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One of the simplest and most meaningful ways to begin is by pronouncing the words we already encounter daily with accuracy and care. Hawaiian is an oral language carried through voice and relationship. When we take the time to say words correctly, we demonstrate respect for the language and for the poʻe (people) who have worked tirelessly to ensure its survival.
Across our own campus, we have opportunities to do this every day.
Let us honor the names of our places by using them fully:
An attendee at celebrations on May 6, 2023, takes a photo of the new Edith Kanakaʻole mural by artist Kamea Hadar. The mural is located at Edith Kanakaʻole Hall, named after beloved educator Aunty Edith, on the campus of UH Hilo. (Photo: UH System News)
Kanakaʻole Hall, not “K-Hall.” (Formally Edith Kanakaʻole Hall, named after our beloved kumu.)
Waiʻōlino, not “CoBE,” for our College of Business and Economics. (Formally Hānau ʻO Waiʻōlino; waiʻōlino literally means sparkling waters, alluding here to bringing forth waters of wellbeing and prosperity.)
These names are not merely labels for buildings. They carry ʻike (knowledge), history, and meaning. Speaking them in their entirety acknowledges the stories and values embedded within them.
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Using ʻōlelo Hawaiʻi does not require fluency. It simply requires willingness. Each of us already knows words we can begin using more intentionally.
Greet one another with aloha.
Express gratitude with mahalo whenever possible.
Small choices like these help normalize Hawaiian language in our daily interactions and strengthen UH Hilo’s identity as a place grounded in Hawaiʻi.
One of the most common questions I am asked is: How do you respond in ʻōlelo Hawaiʻi when someone says “mahalo” to you?
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Here are three simple and appropriate responses:
ʻAʻole pilikia — It’s no problem.
He mea iki — It is just a little thing.
Noʻu ka hauʻoli — The pleasure is mine.
There is no single correct answer. What matters most is participating in the exchange and allowing the language to live through conversation.
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Aerial view of the UH Hilo campus with Hilo Bay in the distance. UH Hilo’s commitment to Native Hawaiian success and place-based education calls on all of us to help create an environment where ʻōlelo Hawaiʻi is visible, audible, and welcomed. (Archive photo)
UH Hilo holds a unique and important role as Hawaiʻi Island’s university. Our commitment to Native Hawaiian success and place-based education calls on all of us to help create an environment where ʻōlelo Hawaiʻi is visible, audible, and welcomed.
You do not need to wait until you feel ready. You do not need to know many words. The language grows stronger each time it is spoken.
So during Mahina ʻŌlelo Hawaiʻi and throughout the entire year I encourage the UH Hilo ʻohana to:
Use the Hawaiian words you already know.
Pronounce names and places with intention and care.
Greet others with aloha.
Share mahalo often.
Because when we use ʻōlelo Hawaiʻi, we are doing more than speaking words, we are helping to perpetuate and uplift the native language of our home.
E ola ka ʻōlelo Hawaiʻi. Let the Hawaiian language live.
Hawaii Rainbow Warriors Tread Rosenthal, Trevell Jordan and Louis Sakanoko put up a triple block against BYU Cougars Trevor Herget during Wednesday’s NCAA men’s volleyball match at the Bankoh Arena at Stan Sheriff Center.
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Kainoa Wade came on strong to lead another balanced Hawaii attack with 16 kills and the third-ranked Rainbow Warriors responded to a rare set loss in a big way to defeat No. 6 Brigham Young 27-25, 23-25, 25-17, 25-18 tonight.
A Bankoh Arena at Stan Sheriff Center crowd of 4,800, who showed up for a match scheduled just three weeks ago as a late addition to the schedule, saw Hawaii (13-1) drop the second set despite hitting .538.
UH had full command of the rest of the match and finished the night hitting .460 as a team. Louis Sakanoko added 15 kills, six digs and three aces and Adrien Roure had 14 kills in 24 swings.
Middle Travell Jordan posted a season-high seven kills in 11 swings with four blocks and Ofeck Hazan, who came into the match to start the third set, had four kills and two blocks.
Trent Moser had 18 kills to lead the Cougars (13-3), whose previous two losses came in five sets against No. 4 UC Irvine.
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UH’s loss in the second set was just its sixth of the season and third in its 13 wins. Hawaii has won 10 matches in a row.
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The two teams will play again on Friday night at 7.
