Investing in Hawai‘i’s Healthcare—We’ve Already Proven the Model

When Hawai‘i sought to expand its screen industry, lawmakers implemented a predictable incentive: 22% on O‘ahu, 27% on Neighbor Islands, with a $50 million annual cap and a $17 million per-production cap. This approach generated jobs, spending, and tax revenue.

In 2023 alone, productions claiming Hawai‘i’s film credit (25 projects) reported $37.3 million in credits. DBEDT’s own analysis estimates that every $1 in credit generates $4.00 in state GDP (or $2.50 under a conservative redundancy assumption), $2.53 in earnings (or $1.61), and roughly $0.50 in state tax revenues (or $0.35). In dollars, that’s $148.9M – $93.1M in GDP, $94.0M–$59.8M in earnings, and an estimated $18.6M–$13.1M in state tax revenues—from one year’s claims. Hawaii Files

This action demonstrated the political will to stabilize a strategic sector. Healthcare requires the same clarity and urgency, as lives depend on timely support.

Patients across Hawai‘i face long wait times, clinics are at risk of closure, and providers are experiencing burnout. Many Neighbor Island families must travel significant distances, or even leave the state, for care that should be accessible locally. Ensuring aloha and ‘ohana are reflected in healthcare access is essential.

The Legislature has already taken an important step. SB1035 (now law) exempts services paid by Medicare/Medicaid/TRICARE from the GET, effective Jan. 1, 2026, for physicians, dentists, APRNs, and pharmacists. This corrects a long-standing imbalance for safety-net care. But the timeline matters: without bridge support in 2025, some clinics will not make it to 2026.

Likewise, SB8 (APRNs’ jury-duty exemption) is a practical, near-zero-cost way to keep doors open. Pulling even one APRN off a small, rural team can shutter access for an entire community. Aligning APRNs’ exemptions with those of physicians and dentists reduces avoidable disruptions as we rebuild the workforce.

What we’re asking for—modeled on the film-credit recommend the following actions, modeled on the successful film-credit approach: a targeted, time-limited stabilization fund for at-risk Neighbor-Island clinics so SB1035’s relief isn’t theoretical. (The film program shows how predictable incentives keep a sector viable year to year.) Hawaii Files

1. Operational Reliability: Pass SB8 or an equivalent measure to reduce unplanned clinic closures and protect access to care. Enforce prior-authorization reforms to return valuable provider hours to patient care.

2. Oral Health Inclusion That Works on Oral Health Inclusion: While the GET exemption will include dentists starting in 2026, gaps in dental access remain. Convene a focused working group with Senate HHS, dental leadership, and the Task Force to develop clarifying guidance or targeted adjustments for 2026 implementation. The film industry sent a clear, durable signal; the economy responded with jobs, earnings, and tax revenue that exceeded the state’s outlay in many scenarios. In 2023, the credit coincided with $149M–$93M in added GDP and $94M–$60M in earnings, against $37.3M in credits a pragmatic public investment that paid dividends. Hawaii Files

   
   

If we can design effective tax policy to support the film industry, we can do the same to improve healthcare. A society is measured by how it cares for its elders and those in need. In Hawai‘i, aloha should mean timely, local care for all families.

Sources (public)

• Hawai‘i Film Office: Incentive overview, rates, and caps (22%/27%, $50M annual, $17M per-production). filmoffice.hawaii.gov+1

• DBEDT, State Data Book 2024: Economic and Fiscal Impacts of Hawai‘i Film Tax Credit: 2023 (Table 23.41) — 25 productions; $37.3M credit; GDP/earnings/tax-revenue multipliers and totals. Hawaii Files

• DBEDT (Act 217 report, 2024): Program stability through Jan. 1, 2033, and administrative resourcing.