Keynote: ‘The future of healthcare in Hawaii’ with Gov. Josh Green


Shane Ersland


Newly elected Gov. Josh Green, MD, said he will focus on crucial public health initiatives like housing, student loan forgiveness for healthcare workers, and increased Medicaid reimbursements during an inspiring keynote at the 2023 Hawaii State of Reform Health Policy Conference.


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“You’re going to have a healthcare state for the next four years,” Green said. “Healthcare is the great unifier in my mind, when you talk about legislatures, red or blue states. Because it affects us all. It affects our kupuna, it affects our children.”

Green submitted his 2023-2025 budget to the state legislature last month. It includes a proposal for $10 million in 2024 and $20 million in 2025 for the Hawaii State Loan Repayment Program. The program pays for educational loans for primary care and behavioral health providers who care for patients at nonprofit organizations in designated health professional shortage areas in Hawaii. It is designed to incentivize care in areas with the most need. 

“We have already funded this at about $500,000 per year,” Green said. “But we’ve never really gone the full distance on this. We’ve always known we’ve had these needs, but we haven’t done it. Because conceptually, healthcare has all it needs to most people. But we know now that we don’t have all we need.”

The initiative will also help the state recruit healthcare workers to areas that are experiencing healthcare deserts. A recent Healthcare Association of Hawaii report showed that there are almost 4,000 openings for various healthcare jobs throughout the state.

“If we tell people that anyone who comes to Hawaii to provide healthcare for our people will have their loans forgiven, I don’t think there will be any deserts at that point,” Green said.

The budget includes funding proposals to support Hawaii’s homeless. It proposes $15 million in each fiscal year for the Ohana Zones program, and $10.8 million in each fiscal year for homeless services and outreach programs like the Rapid Re-Housing and Housing First programs.

Green said the state’s projected housing demand for 2020-2030 is short by at least 36,000 units. The state has 10,000 homeless people, and 2,000 people who are “chronically homeless,” meaning they have been homeless for more than six months.

“Ten thousand go in and out of the state of homelessness, but 2,000 people have addiction, have mental illness, have PTSD, have been traumatized, and they can’t break the cycle unless we change the system,” Green said.

Green also plans to increase state Medicaid payments by $30 million over the next two years.

Hawaii has 460,000 people on Medicaid, with a small percentage of people with chronic needs utilizing a high percentage of Medicaid dollars. 

“Now, our high utilization can be addressed, and if we address it with cultural competency, housing, prevention, and trauma-informed care it starts to shrink,” Green said. “And the budget gets a little easier to manage.”

The budget also includes a proposal for $50 million for capital improvements to expand Hilo Medical Center’s emergency room.