What’s Past is Prologue

All the work of legislators, advocates, and the public since January’s opening day now boils down to a couple of weeks of conference committees.  In a memo issued jointly by the Senate President and House Speaker, conference procedures will be effective from 8:00 a.m. April 17th  through midnight April 28th.

Very few bills come out unamended by one side or another, so conference is where differences are ironed out or, in some cases, bills remain in an unresolved twilight.  Assigned conference chairs wield considerable power over the proceedings with so-called “managers” speaking only when spoken to.  Conference committees typically meet daily to check in and discuss their differences and strategies, if any, to negotiate agreements.

Since a much larger number of bills than one might expect are deemed to have fiscal implications, even when the conferees come to an agreement, the deal isn’t done until the money committees give their consent.  As a practical matter, this often means that bills can’t be wrapped up until the budget is passed.  In past years, bills that required an appropriation might be held up until midnight on final decking day, leaving advocates to bite their nails as the clock ticked down.  This year, committees are required to wrap up their work by 6:00 p.m. on the evenings of final decking, April 27th for non-fiscal bills, and the 28th for fiscal bills.  In the midst of all this, concurrent resolutions are still being heard.  In case of disagreement between the houses on a reso, the measure dies.

The two issues I think will be most interesting in the coming days are SB502, expanding commercial coverage for in vitro fertilization procedures for surrogates for same-sex male couples and HCR56, a House Concurrent Resolution that asks the Attorney General to study the legal aspects of surrogacy arrangements.  These are not currently addressed in state law and, given the diverse ethical, legal, health, and public policy issues that arise, it seems that Hawaii would be wise to support the thoughtful development of a legal armature to protect surrogates, prospective parents, providers, and insurers before requiring coverage.

The second issue is HB552, the bill that would address repeal of the Affordable Care Act.  This bill would, among other things, maintain the individual mandate but create a program to make coverage affordable.  It would also adjust the definitions of Essential Health Benefits both for Prepaid-compliant commercial plans and for the so-called Medicaid-Plus program proposed in the bill.  Kudos for our legislature to propose and advance such a measure!  But, given the continued uncertainty about federal repeal/replace and the complexity of establishing the programs contemplated in the bill, the legislative working group named in HB552 is the most practical outcome likely.