Hawaii Medicaid Program Overview

Enrollment, funding, and managed care facts for Hawaii Medicaid.

Get Hawaii's Medicaid Fee Schedule →
0.39-0.43M
Enrolled
Expanded
ACA expansion status
59.68%
Federal match (FMAP), FFY2026
100%
In managed care

Enrollment

Hawaii Medicaid covered approximately 0.39-0.43M people. Two independent sources give different-period figures for total Hawaii Medicaid/CHIP enrollment: KFF's state indicator (392,022, May 2026) and CMS's 2024 Medicaid Managed Care Enrollment and Program Characteristics report (432,222 total Medicaid enrollees, July 1, 2024). Consistent with continued post-pandemic 'unwinding' enrollment decline between mid-2024 and mid-2026, not a data error. Reported as a range rather than a single false-precision number.

Funding & federal match

Hawaii has adopted ACA Medicaid expansion, effective 2014-01-01.

For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Hawaii's Federal Medical Assistance Percentage (FMAP) is 59.68%.

Delivery system & managed care

A large share of Hawaii Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 100% of Medicaid enrollees.

Waivers

Hawaii operates Medicaid managed care under the Hawaii QUEST Integration, a Section 1115 demonstration waiver. Comprehensive Section 1115 demonstration that operates nearly all of Hawaii's Medicaid program (including dual eligibles) through an integrated managed care delivery system. Originally approved July 16, 1993, effective August 1, 1994 (as QUEST, later QUEST Integration); most recently extended through December 31, 2029, with recent amendments covering continuous eligibility and health-related social needs payments.

Frequently Asked Questions

Yes. Hawaii has adopted ACA Medicaid expansion. Effective 2014-01-01.

Get Hawaii's Free Medicaid Fee Schedule

Request actual Hawaii Medicaid reimbursement rates by billing code — free, delivered as a CSV.

Please use a company email — personal/free email addresses aren't accepted.

Comma-separated, up to 200 codes.

Free for up to 5 states. Rates reflect the most recent data Medlyze has on file as of each row's effective date and may not capture the latest state updates — verify against your state Medicaid agency before billing.