Health Care Merger Places Hawai‘i’s Well-Being at Risk

News release from Queen’s Hospital, Feb 2026

When one organization controls both how care is delivered and how much it costs, Hawai‘i’s families and businesses bear the consequences.

Hawai‘i already struggles with some of the highest health care costs in the nation. Families, kūpuna, and small businesses are doing everything they can to keep up. At The Queen’s Health Systems, we believe strongly that a merger between HMSA and Hawaii Pacific Health (HPH) raises serious and immediate concerns for all Hawai‘i residents.

Experience from other states shows that when insurers and care providers merge, costs rise, access narrows, and the community ultimately loses. And when one entity gains control over both the financing and delivery of care, critical services can be pulled away from the hospitals that depend on them to stay open. These are exactly the kind of unintended consequence other states have seen.

The risk isn’t theoretical. Hawai‘i’s independent hospitals and rural communities could be placed under new financial pressure. Small businesses could face premium increases they cannot absorb. Families could see fewer local care options as decisions move farther away from the community and closer to a single corporate structure.

When polled, a strong majority of Hawai‘i residents oppose a merger because of concerns over a monopoly and access. They prefer steady, practical improvements, not major changes that could disrupt access to care or place essential services in jeopardy. A merger of this scale could alter our health care landscape for decades.

Before any decision is made, Hawai‘i deserves a full, independent review that asks hard questions and puts the needs of our community first.

A decision this big should strengthen our entire health system. It should not favor one part at the expense of all others.

In 1859, Queen Emma and King Kamehameha IV set us on a mission to improve the health of Native Hawaiians and all the people of Hawai‘i. For more than 165 years since then, Queen’s providers and staff have been dedicated to upholding their legacy and carrying on this vital work. Our founders’ compassion and commitment set the lens through which we view changes affecting the well-being of our state’s residents. Looking through that lens today, we foresee that if the proposed HMSA-HPH merger were allowed to happen, the people of Hawai‘i would experience higher health care costs, less choice, and a widened inequality in health outcomes.

We think this proposed merger needs to be considered with great care, and our communities deserve to fully understand its likely consequences. Given our state’s already high cost of living, our leaders need to assess the economic impact this merger would have on our entire population, especially at a time when Hawai‘i businesses are struggling to attract and retain talent, our aging population needs and deserves top-quality health care, and the federal government is making troubling changes to Medicare and Medicaid.

The Queen’s Health Systems serves as the primary safety net for medical practitioners throughout Hawai‘i. In situations when other providers cannot manage a patient’s care on their own, sending the patient to Queen’s is often the first – and sometimes only – alternative.

Accepting these patients aligns with our 165-year-old mission to improve the health and well-being of all the people of Hawai‘i, and it is in this spirit that we call attention to the risks of the proposed HMSA-HPH merger. Approving the merger will weaken the state’s health care system, raising costs, eroding quality and reducing competition with effects that disproportionately disadvantage the poor, kūpuna and Native Hawaiians. These impacts will be exacerbated further if the Trump Administration’s “Big Beautiful Bill” drives people out of the Medicare and Medicaid systems, as many are forecasting.