Hawaii Medicaid and SCHIP Waivers

Section 1115 Waiver – Hawaii’s QUEST Expanded [1] (Quality care, ensuring Universal access, encouraging Efficient utilization, Stabilizing costs, and Transforming the way health care is provided to public clients) demonstration was originally approved by the Centers for Medicare & Medicaid Services (CMS) in 1993. Since that time, Hawaii has continued to enhance this coverage initiative to include additional populations and benefits. Under this section 1115 waiver program, the state uses a managed care delivery system to create efficiencies in the Medicaid program while extending coverage to individuals who would not otherwise be covered. Since 1994, the QUEST program has expanded coverage to pregnant women with incomes up to 185 percent of the federal poverty level (FPL); all children ages 0-19 with incomes up to 300 percent of the FPL; and adults with incomes at or below 100 percent of the FPL. This demonstration program works in partnership with the Hawaii Prepaid Health Care Act program (see below) in an unprecedented State public/private partnership that directly impacts the rate of uninsurance in the State.