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Trump Won’t Stop Attacking Obamacare. That’s Why Hawaii Democrats Moved to Protect It.

Nicole Knight

Democratic-held state legislatures have moved to preserve Obamacare provisions. Last year, at least ten states advanced bills mirroring and, in some cases, expanding the ACA birth control benefit.

Hawaii is poised to become the latest state to preserve provisions of the Affordable Care Act (ACA) as a safeguard against the Trump administration’s attacks.

A bill passed this month by the state’s Democratic-led legislature prohibits insurers from denying coverage because of pre-existing conditions and allows young adults to stay on a parent or guardian’s plan until age 26. The legislation bars insurers from charging women more for coverage simply because of their gender.

The measure was sent to Gov. David Ige (D), whose office said Thursday the bill will undergo a policy and legal review. Any bill that is not vetoed by July 10 will become law with or without the governor’s signature.

The Hawaii Women’s Legislative Caucus advanced the bill as an antidote to repeated attacks on President Obama’s signature health-care law, known as Obamacare. A conference committee of Hawaii lawmakers working on the bill said state-level action was needed because the state’s Hawaii Prepaid Health Care Act may not preserve ACA provisions.

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U.S. congressional Republicans, after a trio of failed repeal attempts last July, voted late last year to roll back the ACA’s individual mandate, which required individuals to maintain health insurance or face a penalty. Last month, 20 attorneys general led by Texas Attorney General Ken Paxton (R) filed a lawsuit challenging the ACA.

Meanwhile, a federal court has blocked the Trump administration from taking steps to undermine the ACA’s birth control benefit, which widely guaranteed health insurance coverage of birth control without a co-pay.

Amid this turmoil, Democratic-held states have moved to preserve Obamacare provisions in state law. Last year, at least ten states advanced bills mirroring and, in some cases, expanding the ACA birth control benefit. Maine’s legislature last month passed a bill to prohibit insurers from denying insurance because of pre-existing conditions. But the state senate fell short of the votes needed to override the Republican governor’s veto of the bill, as the Associated Press reported.

An estimated 20 million people gained health insurance under the ACA, which narrowed racial and ethnic disparities in health coverage.

In testimony supporting the Hawaii legislation, the state insurance commissioner noted the bill would ensure Hawaii maintains one of the lowest uninsured rates in the United States. Only 5 percent of Hawaiians lack insurance, according to a Kaiser Family Foundation analysis, while the national uninsured rate stands at 9 percent. The ACA has led to insurance gains among the more than one-quarter million Hawaii women of reproductive age, according to the Guttmacher Institute.

Prior to the ACA, Hawaii women were charged as much as 23 percent more than men for the same coverage, said Laurie Field, Hawaii legislative director for Planned Parenthood Votes Northwest and Hawaii, in testimony supporting the bill.

The ACA is largely judged along partisan lines. The latest poll by the Kaiser Family Foundation found almost half of the public (49 percent) and most Democrats (79 percent) view Obamacare favorably. But 43 percent of the public and a majority of Republicans (79 percent) take an unfavorable view of the law.

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