5 Things Hawaii: US Senate, Marcus Oshiro, Schatz bill

Summer is almost over, school is getting started, and Congress is back to work. My summer included a trip to Italy, seeing the total eclipse, and spending 6 hours on an 18″ ledge 50 feet above the ocean. Thanks to the US Navy for saving me and my kids from a hike along the coast that got away from us. It’s a good reminder:  in the end, when it matters most, we are all dependent on our community, our tribe, our ohana to make it. Here’s the story.

Everything comes back around, doesn’t it?  So, thank you for everything you’re doing to help your community, your tribe, and your ohana. It matters.


1.  Elections, appointments, musical chairs

U.S. Representative Colleen Hanabusa has announced that she is planning to run for governor in 2018 against incumbent Governor Ige. The race for lieutenant governor is getting crowded, even as incumbent Shan Tsutsui may resign his seat early to campaign for mayor of Maui. Senator Josh Green has announced his candidacy for Lt. Gov and Hawaii County Councilmember Dru Kanuha will run for Green’s Senate seat. Senator Jill Tokuda announced her plans to run after being ousted as Chair of the Senate Ways and Means Committee; Democratic Reps. Ken Ito and Jarrett Keohokalole plan to run for her vacated Senate seat. Maui County Mayor Alan Arakawa is also running for Lt. Gov, but believes Kauai County Mayor Bernard Carvalho would be a strong contender if he enters the race.

Representative Marcus Oshiro has stepped down from his position in the legislature after being appointed by Governor Ige to the Hawaii Labor Relations Board as Chairperson and Representative to the Public. Representative John Mizuno has been appointed Chairman of the newly combined committees of Health and Human Services.


2.  Podcast: Former Rep. Marcus Oshiro

Speaking of Rep. Oshiro, we caught up with him for a podcast interview during a recent Council of State Governments conference.  He didn’t tip his hand about the appointment to chair the Hawaii Labor Relations Board, but we did talk at length about some of the policies and politics of health care in Hawaii.

Rep. Oshiro served in the House since 1994.  He held leadership positions over that time, including as Majority Leader.  You’ll hear in the podcast his enduring enthusiasm for representing his district, something he still gets excited about.

The Democratic Party now has another three weeks to send Gov. Ige three names for him to consider to fill Rep. Oshiro’s seat. Gov. Ige must select an appointee no later than 60 days following the vacancy coming open.


3.  Sen. Schatz bill to open Medicaid

Sen. Brian Schatz is getting a lot of credit from federal policy observers for his bill that would allow states to open up Medicaid to any willing purchaser, regardless of income. It’s a bill that aligns with a Nevada bill, which passed the legislature before being vetoed by the governor. Washington State has a similar bill, as well.

The bill is a long shot in the current political climate – for political reasons rather than policy. However, the bill represents the most interesting policy ideas to come from the Democrats since the passage of the ACA, and could well get rolled into a Senate compromise bill due out later this month.


4.  US Senate HELP committee and the Cassidy-Graham healthcare bill

The first constructive hearings on health care this year are being held in the US Senate Health, Education, Labor and Pensions (HELP) Committee this week.  Yesterday, insurance commissioners testified. Today, it was a bi-partisan group of governors. Two more hearings are next week.

Sen. Alexander (R-TN) and Sen. Murray (D-WA) lead the committee. They hope to have a bill out of committee by the end of the month with a bi-partisan vote. I’m told funding for cost sharing (CSRs) and some language to strengthen waiver authority for CMS under the 1332 section will likely both be in there with bi-partisan support.

But, if the bill does pass, and gets into Conference Committee, it’s possible it could get re-written entirely before it comes back for a vote. This was Sen. McConnell’s strategy with the “skinny repeal” amendment.

And, given that Sen. McCain has reportedly changed his position to support a replacement bill from Sen. Cassidy and Sen. Graham, it’s entirely possible there are 50 votes for a fundamental change to the ACA.


5. Video:  Mark Marabella

Mark Marabella from Mountain Pacific Quality Health joins us in this edition of “What They’re Watching” to discuss the importance of giving patients stewardship of their health. He’s thinking through the questions related to exactly how to drive that elusive patient engagement.

“Well the framework of the system is not going to be there in the future, we know that. So one of the changes we do know is that you have to be the first link in your chain of care. So it’s no longer here and here, and you can’t flip it because it’d be too hard for the patients, but it could be horizontal. We could look at this as peer-based, community-first.”