State-Level Benefits and Restrictions for Non-Citizens in Hawaii

Key Takeaways

• HB 1349 proposes Medicaid expansion for Hawaii children and pregnant persons, regardless of immigration status, starting July 7, 2025.
• Hawaii Health Access Program offers subsidized health coverage for non-citizens with income up to 300% federal poverty level.
• Limited Purpose Driver’s License allows non-citizens to drive legally without requiring legal presence or Social Security number.

Hawaii Moves Toward Greater Inclusion for Non-Citizens: Medicaid Expansion, HB 1349, and State Benefits

As of July 7, 2025, Hawaii stands out for its efforts to include non-citizens in key public benefits, especially in healthcare and transportation. The state is currently considering a major change through House Bill 1349 (HB 1349), which would expand Medicaid coverage to children and pregnant persons regardless of immigration status. This move, along with existing programs like the Hawaii Health Access Program and the Limited Purpose Driver’s License, shows Hawaii’s commitment to health equity and community inclusion. Here’s a detailed look at what’s available, what’s changing, and what it means for non-citizens living in Hawaii.

Who Is Affected and What’s Changing?

Who: Non-citizens in Hawaii, including undocumented immigrants, lawful permanent residents, and mixed-status families.

What: Access to healthcare (Medicaid, Hawaii Health Access Program), driver’s licenses, and other public benefits.

When: As of July 7, 2025, with HB 1349 under active consideration in the Hawaii State Legislature.

Where: Statewide, with some programs limited to certain islands or service areas.

Why: To address health disparities, improve access to basic services, and promote inclusion for all residents, regardless of immigration status.

How: Through state legislation (HB 1349), private-public partnerships (Hawaii Health Access Program), and county-level policies (Limited Purpose Driver’s License).

Let’s break down each area in detail, starting with healthcare.

Healthcare Access: Medicaid Expansion and the Hawaii Health Access Program

HB 1349: Medicaid Expansion for Non-Citizens

The most important development in 2025 is the proposed Medicaid expansion under HB 1349. This bill aims to allow children and pregnant persons to get Medicaid coverage, no matter their immigration status. Right now, about 500 pregnant persons and their children in Hawaii are denied Medicaid, CHIP (Children’s Health Insurance Program), and health insurance exchange coverage because of their immigration status.

• Current Status: As of July 7, 2025, HB 1349 has not yet become law. The bill is still being debated in the Hawaii State Legislature.
• If Passed: The Department of Human Services would get new funds to provide Medicaid to income-qualified pregnant persons and children, regardless of immigration status.
• Support: Health advocacy groups, including the American Lung Association, strongly support HB 1349. They argue that expanding Medicaid would help reduce health problems, lower the risk of premature birth and infant death, and make healthcare more fair for everyone in Hawaii.

Why HB 1349 Matters

If HB 1349 passes, Hawaii would join a small but growing group of states that offer Medicaid to all children and pregnant persons, regardless of immigration status. This would be a big step toward health equity, especially for immigrant families who often face barriers to care. According to analysis by VisaVerge.com, such expansions have been linked to better health outcomes and lower emergency room costs in other states.

Hawaii Health Access Program: A Safety Net for Non-Citizens

While HB 1349 is still pending, the Hawaii Health Access Program already provides a lifeline for many non-citizens. Sponsored by Kaiser Permanente, this program offers subsidized health coverage for low-income people who can’t get other public or private insurance.

• Who Can Apply: U.S. citizenship is not required. Applicants must live in the Kaiser service area (Oahu or Maui), have a household income up to 300% of the federal poverty level (FPL), and not qualify for other health coverage like Medicaid, Medicare, or employer-based plans.
• Income Limits (2025):
  • Individual: $53,970 per year
  • Family of 4: $110,940 per year
• How to Apply: Applicants need to fill out a subsidy application form, provide proof of income and residency, and submit these documents to Kaiser Permanente. The program covers most out-of-pocket costs and monthly premiums for the KP HI Standard Platinum 0/10 plan.
• No Impact on Immigration Status: The Hawaii Health Access Program is not considered a “public benefit” under federal immigration law. This means joining the program will not hurt your chances of getting a green card or U.S. citizenship.

For more details and to access the application form, visit the Kaiser Permanente Charitable Health website.

QUEST (Medicaid) and Pending Changes

Currently, Hawaii’s Medicaid program (called QUEST) is open to U.S.-born individuals, lawful permanent residents, and some other qualified immigrants. Undocumented immigrants are not eligible, except for emergency medical services. If HB 1349 passes, QUEST would expand to include children and pregnant persons regardless of immigration status.

Other Health Coverage Options

• Emergency Medicaid: Available to undocumented immigrants only for emergency medical needs.
• Private Insurance: Non-citizens can buy private health insurance, but it is often expensive and hard to get without a Social Security number.

Driver’s Licenses: Limited Purpose Option for Non-Citizens

Limited Purpose Driver’s License

Since January 2016, Hawaii has allowed counties to issue Limited Purpose Driver’s Licenses to people who cannot show proof of legal presence or a Social Security number. This is especially helpful for undocumented immigrants and others who lack traditional identification.

• What It Is: A driver’s license that lets you drive legally in Hawaii but is not REAL ID compliant. You cannot use it to board a plane or enter federal buildings.
• Who Can Apply: Anyone who can provide proof of legal name, date of birth, and Hawaii residence. No need to show legal presence or a Social Security number.
• How to Apply:
  1. Gather documents showing your name, date of birth, and Hawaii address.
  2. Go to your local county DMV office.
  3. Fill out the driver’s license application form.
  4. Submit your documents.
  5. Take any required written and road tests.
  6. If approved, you’ll get your Limited Purpose Driver’s License.

For more information, visit the Honolulu Department of Customer Services website.

Why This Matters

Having a driver’s license helps non-citizens get to work, take their kids to school, and participate in community life. While the Limited Purpose Driver’s License does not give any immigration benefits, it removes a major barrier for undocumented residents.

Other Public Benefits: Food Assistance and Federal Programs

SNAP (Food Assistance)

• Eligibility: Only U.S. citizens and certain lawfully present non-citizens can get SNAP (Supplemental Nutrition Assistance Program) benefits. Undocumented immigrants are not eligible.
• Mixed-Status Families: If some family members are eligible (for example, U.S.-born children), they can receive SNAP, but undocumented family members cannot.

Federal Public Benefits

Most federal public benefits, including Medicaid (except for emergencies), CHIP, and TANF (Temporary Assistance for Needy Families), are not available to undocumented immigrants. Some state-funded programs, like the Hawaii Health Access Program, are open to all residents regardless of immigration status.

Background: Hawaii’s Approach to Non-Citizen Benefits

A History of Inclusion

Hawaii has a long history of trying to include all residents in basic services, even when federal law sets limits. The state has often gone further than others in providing health coverage to low-income people. The Hawaii Health Access Program and the proposed Medicaid expansion under HB 1349 are part of this tradition.

Why Now?

Advocacy groups and health experts say that making healthcare and driver’s licenses available to non-citizens helps everyone. When people can see a doctor or drive legally, they are healthier, more productive, and better able to support their families.

Expert Perspectives

• State Legislature: Lawmakers are debating HB 1349, with many supporting it as a way to improve health equity.
• Kaiser Permanente: Runs the Hawaii Health Access Program and supports expanding health coverage.
• Advocacy Groups: Organizations like the American Lung Association and immigrant rights groups are pushing for more access to healthcare and driver’s licenses.
• Department of Human Services: Would oversee expanded Medicaid coverage if HB 1349 passes.

Step-by-Step: How to Apply for Key Benefits

Hawaii Health Access Program

1. Check Eligibility: Make sure you live in Oahu or Maui, meet income limits, and do not qualify for other health coverage.
2. Gather Documents: Collect proof of income, residency, and identity.
3. Complete Application: Download and fill out the subsidy application form from the Kaiser Permanente Charitable Health website.
4. Submit Application: Send your form and documents to the address listed on the website.
5. Wait for Approval: If approved, you’ll get information about your subsidized health plan.

Limited Purpose Driver’s License

1. Gather Documents: Proof of legal name, date of birth, and Hawaii address.
2. Visit DMV: Go to your local county DMV office.
3. Complete Application: Fill out the driver’s license form.
4. Provide Documents: Submit your proof of identity and residency.
5. Take Tests: Complete any required written and road tests.
6. Receive License: If approved, you’ll get your Limited Purpose Driver’s License.

Implications for Stakeholders

For Immigrants and Mixed-Status Families

• Healthcare: If HB 1349 passes, more children and pregnant persons will get the care they need, leading to healthier families and communities.
• Driver’s Licenses: The Limited Purpose Driver’s License helps undocumented immigrants participate in daily life and reduces the risk of driving without a license.

For Employers

• Workforce Stability: Employees with access to healthcare and legal driving privileges are more reliable and productive.
• Community Impact: Healthier workers mean fewer sick days and lower healthcare costs for everyone.

For Healthcare Providers

• Lower Emergency Costs: When more people have regular healthcare, hospitals see fewer expensive emergency visits.
• Better Health Outcomes: Early and regular care leads to healthier pregnancies, children, and adults.

For the State

• Health Equity: Expanding Medicaid and other benefits helps close gaps between different groups.
• Legal and Policy Leadership: Hawaii can serve as a model for other states looking to include non-citizens in public benefits.

Future Outlook: What’s Next for Non-Citizens in Hawaii?

HB 1349: A Turning Point

If HB 1349 becomes law, Hawaii will take a big step toward making healthcare available to all children and pregnant persons, regardless of immigration status. This could inspire other states to follow suit.

Ongoing Advocacy

Health and immigrant rights groups continue to push for broader access to public benefits and driver’s licenses. They argue that inclusion benefits everyone, not just immigrants.

Challenges Remain

Federal rules still block undocumented immigrants from most public benefits. However, Hawaii’s state-funded programs and policies show what’s possible at the state level.

Summary Table: Key Benefits and Restrictions for Non-Citizens in Hawaii (2025)

Where to Get More Information

• Hawaii Health Access Program: Kaiser Permanente Charitable Health website
• Limited Purpose Driver’s License: Honolulu Department of Customer Services
• Medicaid and QUEST: Hawaii Department of Human Services
• SNAP: USDA Food and Nutrition Service

Conclusion and Practical Guidance

Hawaii’s approach to non-citizen benefits is changing, with HB 1349 at the center of the debate. As of July 2025, non-citizens can access the Hawaii Health Access Program and Limited Purpose Driver’s Licenses, regardless of immigration status. Medicaid (QUEST) is still limited to lawful residents, but HB 1349 could soon open the door to more children and pregnant persons. SNAP and most federal benefits remain out of reach for undocumented immigrants.

If you or your family are non-citizens living in Hawaii, check your eligibility for the Hawaii Health Access Program and consider applying for a Limited Purpose Driver’s License if you need to drive. Stay informed about HB 1349 and other policy changes by following updates from the Hawaii State Legislature and advocacy groups. For official information on Medicaid and other benefits, visit the Hawaii Department of Human Services.

Hawaii’s efforts show that state-level policies can make a real difference in the lives of immigrants and their families. As reported by VisaVerge.com, these changes not only improve health and safety but also help build stronger, more inclusive communities.

Learn Today

HB 1349 → A Hawaii legislative bill proposing Medicaid coverage expansion to children and pregnant persons regardless of immigration status.
Medicaid → A government health insurance program for low-income individuals, with specific eligibility depending on state laws and immigration status.
Limited Purpose Driver’s License → A driving permit in Hawaii for individuals without proof of legal presence or Social Security number, not REAL ID compliant.
Hawaii Health Access Program → A subsidized health insurance program sponsored by Kaiser Permanente for low-income residents regardless of citizenship.
QUEST → Hawaii’s Medicaid program providing health coverage primarily to lawful residents and some immigrants, with limited access for undocumented persons.

This Article in a Nutshell

Hawaii is advancing inclusion with HB 1349 Medicaid expansion and existing programs, improving healthcare and driving access for non-citizens statewide by July 2025.
— By VisaVerge.com