As the state Legislature gears up for a new session, there are plenty of issues on the table. Concerns about the cost of living are deepened by rising health care premiums for tens of thousands across the islands.
There are also questions about how state and local law enforcement will interact with stepped-up immigration enforcement by federal officers.
The Conversation checked in with Gov. Josh Green this morning to get his thoughts on these and other pressing issues.
Interview highlights
On immigration enforcement in Hawaiʻi
GOV. JOSH GREEN: The ramping up of ICE (Immigration and Customs Enforcement) activity is unfortunately creating these moments. And we're hoping that there can be a kind of de-escalation of the whole process. We've been in touch with the Department of Homeland Security constantly, and our position is very clear: local law enforcement should be doing what they do locally, which is taking care of crime and concerns, so they should not be working on immigration work, and that's why we don't authorize them to do that. Beyond that, the only time that we really feel that there should be some participation between the state of Hawaiʻi and the Department of Homeland Security on an immigration matter is if there's been a real criminal activity that merits someone leaving. So, for serious criminals, of course, we support them being sent back to their home country, but everything else really should be much more peaceful. And we're a state that's built on immigration. We're mindful of our roots, and we want to honor them.
On health care, HMSA-HPH partnership
GREEN: It is going to be somewhat controversial. I have a lot of trust in all the partners who are considering coming together. However, we have to also respect the concerns that, say, Queen's hospital has, or the HHSC system — that's Hawaiʻi Health Systems Corporation. So my attorney general is being briefed and talking to them already at length. ... We already are kind of a small family of health care plans. There's only a couple of health insurers and only a couple of health care providers. So whatever happens, we have to make sure that the providers are cared for, the doctors and nurse practitioners, and PAs (physician assistants), so they can keep delivering care. That's the most important thing to me. ...
You have this proposal of a large merger, which would streamline administrative activities and theoretically decrease the rate of increase of costs. And at the same time, I was able to land this really large grant for Hawaiʻi, which is the Hawaiʻi Rural Health Transformation Plan. ... This is $188.9 million per year, times five years. So, it'll be about $940 million. Look, we're going to be able to do some special things. I came to Hawaiʻi with the National Health Service Corps to be a doc in rural Hawaiʻi. So I'm very familiar about our needs, and this money can help expand our rural health information network so that we can share notes and share people's care between the rural areas and the urban areas when people need specialists.
It's going to do a lot more telehealth. And expanding telehealth to the rural communities is great because I was in the ER a lot of the time, and we often need follow-up for patients from, say, a specialist or a surgeon, just a quick check-in, and telehealth can work for that. Then we're going to also enhance the number of providers we have. For instance, we want to expand the pipeline all the way back to high school facilities. So we've been working with the Healthcare Association [of Hawaii] already with scholarships and expanding those kinds of programs all the way up and through medical school and residency. That program will get funded much better because of this grant.
And then finally, our rural health network for respite care. As you know, I need respite care for people that have been houseless, but come out of the hospital and get sicker, and they go back into the hospital, and they cost a lot of resources, and they suffer. So all of those things, and then some more, like the value-based care programs, they're going to be funded now.
On legislative priorities
GREEN: What's front and center is affordability. We have crushing costs across the country, but of course, Hawaiʻi is very expensive, and housing is our biggest driver of cost, so we're going to continue to promote affordable housing projects, public housing projects. That's critical to us. Health care is important, and that's another cost driver. That's why we will entertain the partnership proposals. But we're also going to continue to do all the things that you heard about on this rural health care transformation grant. Food costs are going to be supported.
All of this goes to where we want all of our bills and policies to land, which is affordability. We're going to continue to build housing, and I'm under emergency housing rules for that purpose alone. The validation came from the (Hawaiʻi) Supreme Court, you'll see appropriations, of course, $50 million in bonds for a new medical center in Kona, all kinds of emergency health care services in that grant, climate resiliency. We put in the largest tax breaks ever in our state for working families, but the parts that are going to be more difficult to afford going forward are for people who are a little bit more affluent, who got extra breaks from the federal government. So the current proposal is to leave everything in place. People keep all their tax breaks through '26, but the higher-end cuts, especially that would help people who maybe had a little more money, would be paused. [We] would take $1.8 billion back, and we would reinvest $600 million into food security and child care for working families. That's the plan.
This story aired on The Conversation on Jan. 15, 2026. The Conversation airs weekdays at 11 a.m. Hannah Kaʻiulani Coburn adapted this interview for the web.
