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Editor’s note: Mililani Trask has filed papers to run for the OHA board.

Native Hawaiians are an endangered species. Seriously. Several items of news this week confirm that. A study by the says Native Hawaiians have a life expectancy that is 6.2 years less than whites and Asians.

In other news, we were told that Hawaii had one of the lowest enrollments for the Affordable Care Act.

One explanation offered for that was that 92 percent of the population was already protected through Hawaii’s Prepaid Health Care Act that guaranteed coverage to anyone working 20 hours or more.

It is true that Hawaii offered better health care coverage to start with compared to the mainland.

But tell that to poor, hurting rural Native Hawaiian communities where diabetes, obesity and heart disease are prematurely cutting short lives for want of adequate education, care and access to proper treatment.

Has OHA done enough to make sure these communities are aware of the ACA and understand its critical importance to their health?

When I was a trustee at the Office of Hawaiian Affairs (OHA) in 1998, we looked at the possibility of helping our beneficiaries get community health coverage. We found pukas in healthcare coverage that needed to be filled. OHA can play an important role in filling them.

The Affordable Care Act (ACA) gives us the opportunity to actually do something about providing better coverage in ways that were not available in 1998. OHA cannot foot everyone’s medical bills but it sure can do something about keeping those bills from mounting by ensuring that our beneficiaries are getting the care, including preventative care and education.

One of the things we noticed then, when we were examining the state of healthcare for our beneficiaries, was the really high rates of breast cancer manifesting at a really young age. But insurance at that time did not cover the costs of screening and treating these young women. Back then, coverage began at age 40 — which meant younger women would shrink from getting mammograms or treatment until it was too late. Things are different now.

The ACA empowers OHA to do more for the Health of Beneficiaries

The Affordable Care Act (ACA) has changed the landscape of healthcare for all. Because the ACA has made it impossible for insurance companies to discriminate on the basis of pre-existing conditions; because it allows young people to stay on their parents’ plans; because it emphasizes prevention, and extends Medicaid, because it gives women protections that were previously not available, OHA has an important tool we did not have before to really address the challenge of helping its beneficiaries live longer, healthier lives.

Whether we use this tool wisely and well depends on whether we are open to change and to really listening to the voice of the people and responding to their needs. I have seen it done in Aoetearoam, New Zealand. Some Maori trusts there have embraced socialized medicine and they are looking at the possibility of universal healthcare entitlements. They are looking at the cost of taking out a group policy for supplemental coverage for the 2,000 families in their trust.

Hawaiians should emulate that example. OHA is the perfect platform for the discussion about how this can be done. The state report pointing to the fact that Native Hawaiians enjoy a life span that is 6.2 years less than others should spur us to do much more to get the community engaged in and taking ownership for their health. “Build it and they will come” does not work when you are trying to reach people stuck in small rural towns and communities.

Clearly, just building the Hawaii Health Connector and hoping people would respond — in a climate of active misinformation — was not enough.

About the author: Mililani Trask is the principal of Indigenous Consultants LLC and an internationally recognized expert on human rights and Hawaii land trust issues. As a founding member of the , she worked on issues of community-based economic development, including housing and health. She has filed papers to fun for the OHA board.

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