In 2022, Medicaid transfers in Hawaii totaled $3.19 billion, amounting to $2,218 per capita, or 19.7% of total government transfers in the state, according to information from the Economic Innovation Group.
Among all government transfer programs, Medicaid was the second smallest contributor. Social Security was the largest, totaling $5.47 billion, equating to $3,795 per capita and making up 33.8% of total transfers.
Medicare was the second largest contributor in Hawaii in 2022, accounting for $3.48 billion, averaging $2,415 per capita, and represented 21.5% of transfers in the state. Income Maintenance transfers provided another $2.2 billion, averaging $1,528 per capita and comprising 13.6% of government support, making them the smallest contributors.
Statewide, including all transfer types, government transfer payments totaled $16.18 billion, and accounted for 18.2% of residents’ total income, with an average of $11,236 per resident.
Government transfer payments are non-repayable funds provided by federal, state, or local governments to support individuals in need. These payments aim to stabilize economic conditions and provide financial support during hardships. Key programs include Social Security transfers (retirement benefits), Medicare transfers (healthcare for seniors), Medicaid transfers (healthcare for low-income individuals), and income maintenance transfers (financial assistance for basic needs).
With 18.1% of the population aged 65 and older, Hawaii has a significant demand for programs like Social Security and Medicare. The total per capita income in Hawaii, excluding government transfers was $50,543, which is noticeably below the county’s total income of $61,779, emphasizing the role of government transfers in overall income.
When comparing 2022 to the previous year, Hawaii saw an increase in its Medicaid transfer dependency by 0.3%, reflecting both rising transfer amounts and stagnating or insufficient other sources of income.
Government transfers have long been a modest financial safety net, historically comprising only a small fraction of Americans’ income. However, since the 1970s—sometimes dubbed the “Great Transfer-mation”—dependency has surged from 8.2% (or $2,022 per capita in inflation-adjusted 2022 dollars) in 1970 to 17.6% (or $11,542 per capita) in 2022 nationwide. In Hawaii, reliance on government transfers has similarly increased from 4.5% (or $1,466 per capita) in 1970 to 18.2% (or $11,236 per capita) in 2022, reflecting broader national trends.
According to the Economic Innovation Group’s analysis, these trends are not merely short-term responses to economic pressures but rather reflect a profound, long-term transformation in how government support is integrated into American life. The study illustrates that structural shifts—from rising healthcare expenses and demographic changes to stagnant wages—have significantly increased dependency on government transfers.
| County | Rank | Dependency on Transfers (%) | % Population 65+ | Social Security Transfers (%) | Medicare Transfers (%) | Medicaid Transfers (%) | Income Maintenance Transfers (%) | Per Capita Transfers ($) |
|---|---|---|---|---|---|---|---|---|
| Honolulu County | 1 | 16.6% | 19.6% | 5.6% | 3.5% | 3.2% | 2.2% | $10,759 |
| Hawaii County | 2 | 27.1% | 23.8% | 8.9% | 5.8% | 5.4% | 4.6% | $13,412 |
| Maui + Kalawao County | 3 | 17.8% | 0% | 6.4% | 4.1% | 3.5% | 2.3% | $10,755 |
| Kauai County | 4 | 22.3% | 22.5% | 7.6% | 4.9% | 5.5% | 2.6% | $12,656 |
