5 Things Hawaii: Q&A w/Lance Segawa, Policy cutoff, People on the move

We are holding our first conference focused on federal policy and a multi-state “learning lab” featuring innovations from across the country. Hawaii’s success will be one of our case studies to teach the nation.

We purposely made our conference hours late in the day Washington DC time, so that we could include as many folks from Hawaii as possible. So, you can join the full two-day event. But, not only do you not have to travel to Washington DC. But you won’t have to get up too painfully early to join us! The event will kick off at 7:00 am HST.





With help from Emily Boerger

1. Health policy on the move

Friday marks the deadline for bills to pass out of committee and be submitted to the clerk of the originating chamber. With this in mind, we’ve put together a rundown of some of the health policy bills we’ve been watching that are on the move.

On the list are three telehealth bills including HB472, which makes permanent certain telehealth-related exemptions issued by the Governor, SB970, which would allow the establishment of a physician-patient relationship via telehealth interaction, and SB1258, which would allow for audio-only telehealth visits. Multiple pandemic-related bills, such as SB262 and SB1156 are also moving forward.


2. Lance Segawa on the rural vaccine rollout

With 41 years of leadership experience in health care, Lance Segawa is the Regional Chief Executive Officer at the Hawai’i Health Systems Corporation – Kaua’i Region, which runs two hospitals and five clinics on the rural island of Kaua’i. In this conversation with State of Reform Reporter Sydney Kurle, Segawa discusses pandemic preparation, the vaccine rollout, and the importance of a transparent organizational culture.

Segawa says coordination and collaboration with other organizations has been critical in their vaccine rollout, particularly in a rural area. “We made an agreement early that we would lock hands and work together in vaccinating the community…By doing that, we were able to create consistency in terms of communication for the island community…By making sure that we have our act together in Kaua’i, we’re able to be much more exact with what we needed on a week-to-week basis of vaccine supplies.”


3. Health reform in federal COVID bill

Biden’s $1.9 trillion COVID relief package passed the US House over the weekend. When it goes to the Senate, it’ll land in the Senate Finance, the powerful committee chaired by Oregon Senator Ron Wyden. Wyden will be a keynote speaker at our 2021 State of Reform Federal Health Policy Conference on April 7-8th. State of Reform columnist Jim Capretta outlines the health measures in the bill that “will be significant for policy debates in the years ahead.”

Among the list of changes is an increase in premium tax credits for households receiving insurance through the ACA exchanges. The bill would fully subsidize coverage for households below 150% FPL, increase subsidies for those up to 400% FPL, and would remove the 400% FPL cap. This would allow any household to get coverage through the ACA exchanges with a premium of no more than 8.5% of annual income. A recent analysis estimates that a 60-year-old enrollee in Hawaii at 430% FPL would see an average $107 decrease in the monthly premium of a benchmark silver plan.

4. People on the move

Joy Barua began his new role as Deputy Director with the City & County of Honolulu’s Dept. of Community Services last month. In this position, Barua will oversee about $150 million in grants, investments, and resources to support areas such as housing, job-creation, elderly affairs, and economic and workforce development.

Trish La Chica, formerly the Policy and Advocacy Director at Hawaii Public Health Institute, has started her new role as Community and Government Relations Manager at AlohaCare. And Kathy Raethel, who has served as President of Adventist Health Castle since 2011, has announced she will retire from the role on March 26.


5. Implications of “chronic COVID”

I recently had the opportunity to speak with Dr. Chris Murray, Executive Director of the Institute for Health Metrics and Evaluations (IHME), where I learned something I didn’t know. Murray is yet another national-level keynote speaker at our federal policy conference in April. Based on data from the Novavax COVID vaccine trial, being previously sick with COVID-19 appears to offer no protection from being infected with the new South African strain of the virus.

Without cross-variant immunity, Murray says this data indicates we may be moving to a “world of chronic COVID” where every winter we treat COVID as we do the flu. I outline three immediate things that may change for us in this column. Perhaps the most important is this: hospitals and their current financing models are in trouble. Video of my full conversation with Murray is available here.