04-04-2026, 09:52 PM
Bought gas… or schedule an appointment with a doctor? Doctors in Hawaii are not reimbursed at the same rate for cost of living as comparable cities on the mainland. How will this affect our already limited availability of doctors here? What about specialists who fly to Big Island from Oahu to treat patients here? Gas, fertilizer, electricity, food, and now doctors:
When a Medicare patient in Honolulu goes for a routine, moderately complex, 40-minute follow-up appointment, for example, the feds reimburse the Hawaiʻi doctor $202. A doctor in San Francisco gets about $235, roughly 16% more. Multiplied over the course of the year, it can add up to tens of thousands of dollars less for the Hawaiʻi doctor. Hospitals face the same sort of discrepancy.
“The bottom line is, the Medicare reimbursements we get do not accurately reflect the cost of doing business and providing care in an island state like Hawaiʻi,” U.S. Rep. Jill Tokuda said.
Asked about Congress’ move to limit Hawaiʻi’s funding for Medicaid, state Sen. Angus McKelvey, vice chair of the Senate Health and Human Services Committee, called the One Big Beautiful Bill Act “one big barrel of bullshit.”
https://www.civilbeat.org/2026/04/low-in...ial-cliff/
When a Medicare patient in Honolulu goes for a routine, moderately complex, 40-minute follow-up appointment, for example, the feds reimburse the Hawaiʻi doctor $202. A doctor in San Francisco gets about $235, roughly 16% more. Multiplied over the course of the year, it can add up to tens of thousands of dollars less for the Hawaiʻi doctor. Hospitals face the same sort of discrepancy.
“The bottom line is, the Medicare reimbursements we get do not accurately reflect the cost of doing business and providing care in an island state like Hawaiʻi,” U.S. Rep. Jill Tokuda said.
Asked about Congress’ move to limit Hawaiʻi’s funding for Medicaid, state Sen. Angus McKelvey, vice chair of the Senate Health and Human Services Committee, called the One Big Beautiful Bill Act “one big barrel of bullshit.”
https://www.civilbeat.org/2026/04/low-in...ial-cliff/
“We do this thing not because it is easy, but because we thought it would be easy.”