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In a 60-39 vote, the senate passed the Patient Protection and Affordable Care Act, sending the bill to a conference committee consisting of House and senate members to resolve differences between the two versions of the bill. In the senate bill, Hawaii would receive an exemption that ensures Hawaii’s employer mandated health care law remains in place. This rule of construction will promise that employer provided insurance as mandated by the Hawaii Prepaid Health Care Act is maintained. It is essential that we try to expand availability of health care that we build upon the existing system of coverage in Hawaii rather than replace it. He said the bill will develop access to coverage, improve the quality and availability of health care services and attempt to slow increasing health care costs. The legislation will also make sure that individuals with preexisting conditions will be able to get insurance and prohibit unfair lifetime limits imposed by health insurance companies on individuals. Akaka and Inouye noted that the bill restores a Medicaid allotment to support hospitals that care for significant numbers of Medicaid and uninsured patients. It is anticipated to provide access to $100 million for Hawaii hospitals through fiscal 2019, adding that the state will have to provide matching funds to draw down the federal money. He said the bill also includes financial help for individuals and small businesses having difficulty affording insurance coverage.