by Andrew Walden

For months, Mazie Hirono pledged to vote against the Senate version of Obamacare.  For her, Senate Obamacare just wasn’t socialist enough.  Along with 56 other “progressive” members of Congress, she demanded a program with a public option and denounced the Senate bill as a multi-billion dollar giveaway to the insurance companies.

Hirono’s July 30, 2009 letter explained:

“Any bill that does not provide, at a minimum, for a public option with reimbursement rates based on Medicare rates--not negotiated rates—is unacceptable…. (T)his agreement will result in the public, both as insurance purchasers and as taxpayers, paying ever higher rates to insurance companies.  We simply cannot vote for such a proposal.”

Hirono has maintained this position as recently as February 2, but at the last minute, barely noticed by her “progressive” base, Rep Mazie Hirono has changed her mind.  She now claims the bill will provide all part-time employees with insurance, telling KITV:

"For immediate relief, small business, for example, will be able to get tax credits to get insurance for their employees. Then all the part-time employees in Hawaii who are not covered under the prepaid health care law will be able to look for insurance and be able to afford insurance."

In reality the Senate version of Obamacare makes it illegal for individuals not to purchase their own insurance.  For low-income individuals—including non-citizens in Hawaii under the Compact of Free Association—the nearly bankrupt Medicaid program will be expanded to place them on welfare so they can receive free coverage. 

As Governor Lingle has pointed out, this will punch a $350M hole in the state budget as the State is forced to come up with funds to cover its share of the Medicaid bill and COFA obligations.

While courting Hirono’s vote, Obama even claimed that the “Louisiana Purchase” would benefit Hawaii's recovery from the 2006 Big Island earthquake.  But this may be illusory, because the “Louisiana Purchase” provides aid only to states in which every county has been declared a disaster area.  After the 2006 quake, the Bush administration declared “all four counties” of Hawaii to be a disaster area.  But Hawaii has five counties.  The New Orleans Times-Picayune March 11 pointed out that the failure to include Kalawao County likely renders Hawaii ineligible—but this didn’t stop Obama from telling Fox News, “(The Louisiana Purchase) also affects Hawaii, which went through an earthquake….”

Obviously, Obama’s Fox interview insistence that the “Louisiana Purchase” would also apply to Hawaii, was part of the campaign to buy Hirono’s vote.

The effort to buy Hirono’s support was capped today with hundreds of millions of dollars promised to Hawaii on the front page of the Advertiser: 

Hawai'i and Tennessee could each receive about $100 million in Medicaid payments to help hospitals that treat a disproportionate share of poor and uninsured patients. Until the past few years, the two states had not regularly received extra federal payments because the states have waivers from the traditional Medicaid program — for Quest in Hawai'i and Tenn-Care in Tennessee.

Hawai'i and 10 other states would share in $8.5 billion in extra Medicaid money over a decade for already providing expanded Medicaid coverage, such as benefits for adults who have no children. The bill would require all states to expand Medicaid coverage and federal lawmakers do not want to penalize states that took early action.

But in their rush to buy votes, the Obama administration may have stumbled over its own feet.  As the Advertiser points out:

(State Department of Human Services Director Lillian) Koller said in an interview that it is curious why the extra payments in the bill would be seen as a plus. She said it contradicts the central promise of reform — covering the uninsured — because it presumes hospitals will still be burdened by charity care for the poor and uninsured.

Koller said it shows that Congress has a "lack of confidence in the effectiveness of their national health care reform."

In spite of claims that Hawaii’s “Pre-paid health insurance Act’ will be exempted under the Senate version of Obamacare, the state’s leading insurers aren’t so sure.  The Advertiser reports:

Jennifer Diesman, vice president of government relations at HMSA, said there could be potential conflicts between the Prepaid Health Care Act and provisions of the bill. She asked, for example, whether small businesses would qualify for subsidies to purchase coverage for workers through the insurance exchanges if the health plans have lower benefit packages than required by state law.

"The impact on Hawai'i is a fair bit unknown," she said.

Diesman said HMSA would have to pay a new insurer fee in 2014 while Kaiser would get a break, which could lead to higher premiums in HMSA and an uneven playing field between the competitors.

But Hirono may be distracted by other ‘gifts’ from Obama.  The Kauai Garden Isle today announces “Health offices to receive $3.4M grant.”  The grant recipients and administrators are a who's-who of Hirono cronies on Kauai and Maui who might need a “boost” just in time for campaign season. 

The one group Hirono is surely not listening to are her constituents.  When she returned to Hawaii last summer in the midst of Congressional debate over socialist medicine, Hirono refused to hold any open town hall meeting.  Instead she met with a stacked private-invitation only group of liberal activists on Kauai while Republican Congressional candidate Charles Djou held the State’s only open town hall where all opinions could be heard.

Hirono is also not listening to the protesters on Kauai, the Big Island, or Maui who, once again, Thursday lined the streets of Kahului to denounce Obamacare.

On meet the press this morning, House Majority Leader Steny Hoyer said he “will” have the votes, but could not commit to having the votes at that moment--just hours before the vote.  Republican minority leader John Boehner said, “They do not have the votes.”

Walking into Congress this morning, Speaker Nancy Pelosi was overheard to say, “Steny, we have to get to 217. None of these members wants to be the deciding vote.”

Neil Abercrombie was pledged to be that last vote, but he resigned.

For fighting Obamacare, Hawaii can thank Abercrombie—who claimed to be committed to its passage. 

And for betraying the fight, Hawaii can blame Hirono--who claimed to be solidly opposed.

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ADV: More Hawaii poor would have health care under reform

KITV: Hirono: Health Reform Bill Helps Hawaii

KGI: Health offices to receive $3.4M grant

HFP: GOP’s Ramsay Wharton to challenge Hirono for Outer Islands Congressional Seat

Lingle: Obamacare, COFA, and the upcoming $350M State budget gap: Lingle vs Congressional Delegation

VIDEO: VIDEO: Obama says “Louisiana Purchase” will help with “Earthquake in Hawaii”

NOLA: Louisiana Medicaid fix may also help Hawaii

TPM: Raw Deal: What Were Dems Thinking When They Let Neil Abercrombie Retire?

HFP: In Congress, Hawaii now represented by Lorraine C. Miller