A state plan to scale back health care benefits to about 7,500 adult Micronesians — including no longer covering dialysis treatment or chemotherapy — could be a "death sentence" for some, advocates and patients' relatives warned at a legislative briefing yesterday.

"I'm begging you please to find a solution to help all of us," a tearful Innocenta Sound-Kikku told members of the House Human Services Committee yesterday. Sound-Kikku, 40, said her father has received dialysis for nine years. "How is he going to survive (without it)?" she asked.

The new plan goes into effect Sept. 1, and is aimed at saving the state about $15 million a year. It replaces a comprehensive health care coverage plan the state started providing to low-income, adult Micronesians in 1996, when Congress made them ineligible for federally funded care.

Officials said the state no longer has the money for the comprehensive plan.

Under the new plan, about 100 Micronesians would no longer get their dialysis treatment covered. It's unclear how many would see chemotherapy treatments cut, but advocates put the number at 130 to 160. Also, wheelchairs and transportation to treatment won't be paid for.

State Rep. John Mizuno, House Human Services Committee chairman, said the coverage changes are "morally wrong" and "not acceptable." He also told the more than 75 people who attended the legislative briefing yesterday that he would do his best to "correct this injustice."

The state plan "must have coverage for our dialysis and chemotherapy patients," said Mizuno, D-30th, (Kamehameha Heights, Kalihi Valley, Fort Shafter). "To have a health care plan that may cost the lives of more than 100 people, it's wrong."

EXPENSIVE FOR STATE

But officials say the economic crisis means the state can no longer afford to cover comprehensive health care coverage for the 7,500 Micronesians, who would otherwise be uninsured. And they said there are other ways the patients can seek care, including through community health centers.

They also stressed that children and pregnant women would not see any coverage cuts.

"The state is in a fiscal crisis and simply cannot afford to fund the federal government's obligation anymore," said Dr. Kenneth Fink, administrator for the Med-QUEST division in the state Department of Human Services. He added that Hawai'i is the only state that provides medical assistance to those who move to the United States under the Compact of Free Association.

The compact offers benefits for those from Pacific nations where U.S. nuclear testing took place during the 1950s. It also includes funding for states that see many compact migrants, but officials said the grants cover only a small portion of the costs associated with the population.

Fink said the state spends about $28 million a year on health care for adult Micronesians (excluding pregnant women). In comparison, the state gets about $11 million a year in compact grants to compensate for a variety of services, including health care costs. "We've been providing comprehensive benefits for well over a decade without any substantial federal relief," he said.

TAXPAYER BURDEN

DHS spokeswoman Toni Schwartz added that the burden of the program is falling on taxpayers, who are themselves struggling financially. "A lot of taxpayers may look at this and say, 'Why am I paying for this coverage when I can barely pay for my own?' " she said.

Fink also pointed out that the new coverage plan — called Basic Health Hawaii — still offers far more health care to Micronesians than other states. He added that the state is working with the congressional delegation and with health care providers to find a short-term solution so those with serious chronic illnesses will continue to get life-saving treatment after Sept. 1.

At least one agency has said it will pay for continued treatments out-of-pocket.

In the long term, though, it's still unclear how patients will get the care they need.

Meanwhile, opponents of the plan say they haven't gotten any assurances from the state that dialysis or chemotherapy patients will not simply be cut off. They're also questioning why the program is being implemented so quickly, rather than over the period of six months to a year.

DHS unveiled Basic Health Hawaii in July.

Some patients said they got letters about changes to their coverage just last week.

At the briefing yesterday, dozens of patients and their relatives turned out to speak out against the new plan. "I'm here on behalf of my husband, my children, my family to again ask you to not cut off this type of treatment," Yitha Phillip, whose husband needs dialysis, told lawmakers.

She said her husband would die within two weeks without the treatment.