Obamacare, clean-energy, HMSA changes coming

Jan. 01--Significant changes are in store for 2017 as the health care industry grapples with how to control escalating medical costs and deal with the thousands of Hawaii residents at risk of losing their health insurance if parts of the federal Obamacare law are abolished.

In addition, energy news will continue to dominate headlines as the state moves toward its goal of getting 100 percent of its electric power from renewable sources by 2045.

1. Obamacare now in Trump's hands. Obamacare will take on a new look under President-elect Donald Trump, with parts of the Affordable Care Act likely being repealed.

That raises the question of what will happen to the more than 40,000 people in Hawaii who are covered under President Barack Obama's signature health care law, which requires most Americans to get coverage or pay a penalty.

Trump has said that he favors keeping two Obamacare provisions -- the ban on denying coverage to patients with pre-existing conditions and the requirement that children can remain on their parents' health plan until age 26.

But abolishing other parts of the law could mean thousands of Hawaii residents will have to find health insurance elsewhere or go without. Thousands more who became eligible for Medicaid -- the government health-insurance program for low-income residents -- under an expansion of the program also could lose coverage if the law is repealed. Hawaii received federal funds under Obamacare to expand the Medicaid rolls.

Hawaii spent $130 million and five years building a health insurance exchange to offer Obamacare coverage. The state eventually shut down the Hawaii Health Connector and moved the program to healthcare.gov, the federal exchange.

2. Batteries and electric vehicles. Hawaii will continue to work for 100 percent renewable energy dependence in 2017 with more solar installations, batteries for solar power storage and electric vehicle chargers.

Hawaiian Electric Co., the state's dominant utility, said it expects to achieve the state's 2045 goal faster than expected and customer rooftop solar is projected to be key in getting the utility to 100 percent.

HECO said in plans in December it expects private solar systems to more than double by 2030.

More electric vehicle charging stations will be coming online in 2017 as state agencies, HECO and clean energy nonprofits said they will work together to improve EV infrastructure. HECO plans to add charging stations on the North Shore, in Iwilei and in Waimea on the Big Island.

Energy storage tax credits or rebates will be addressed during the upcoming legislative session, as the only solar incentive program still available for Hawaii residents is one linked to home battery systems.

The solar industry has campaigned for incentives for energy storage, saying making battery systems more attractive is key to increasing their popularity.

3. HMSA rolling out new pay model for doctors. Hawaii Medical Service Association is changing the way it pays primary care doctors in an effort to control costs and improve the health of its roughly 720,000 members.

Beginning in 2017, the state's largest health insurer will reimburse physicians a fixed monthly rate for each patient in a practice, regardless of whether the patient visits the doctor. HMSA started a pilot project of the new payment model with about 100 doctors on April 1. The program will be rolled out to groups of doctors throughout 2017 and replace HMSA's current fee-for-service model, which reimburses doctors based on the number of patient visits and type of service.

Nationally, the move to this new system -- known as capitated payments -- is being driven by the Affordable Care Act and the federal Medicare program in an effort to improve health and contain rising medical costs.

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