The group didn’t trust Mokulele Airlines’ scheduled flights, underscoring the difficulties island residents have accessing health care and other services.

As Biden administration officials descended on Honolulu last week to discuss efforts to advance equity, justice and opportunity for Asian Americans, Native Hawaiians and Pacific Islanders, a small cohort of the president’s aides, led by Rep. Jill Tokuda, chartered a plane to Molokai to assess the island’s shaky health care infrastructure.


The chartered flight on Mokulele Airlines ensured that the federal officials wouldn’t be left stranded overnight on the remote island by delays or cancellations, Tokuda said.

“That’s the only reason that we knew we would get there on time and leave on time, which is really too bad because part of what I wanted them to appreciate is the struggle,” Tokuda said.

The policy advisors’ visit to one of the state’s most isolated islands, where more than 60% of its 7,000 residents are of Native Hawaiian descent, comes as the gulf in access to medical care is widening amid a shortage of air travel options. 

Biden officials chartered a Mokulele Airlines flight to Molokai on Wednesday to tour the island’s medical facilities with an eye toward forging solutions to rural health care challenges. (U.S. Rep. Jill Tokuda photo)

Since the coronavirus pandemic slashed the number of commercial air carriers servicing Molokai and Lanai from three to one, it’s been more challenging for residents to fly in and out. The ongoing disruption has caused many patients to miss pressing appointments with Honolulu doctors — in some cases repeatedly.

It’s also complicated the well-worn practice of sending fly-in doctors to Molokai and Lanai to prop up patient access to care.

The last surviving public airline servicing Molokai and Lanai — Mokulele Airlines — has since become a target of a months-long barrage of customer complaints over lengthy travel delays and flight cancellations. Mokulele executives publicly acknowledged shortcomings primarily affecting Molokai and Lanai residents and promised in March to “step up” service.

Next month the airline will suspend daily flights between Hilo and Kahului in order to boost Molokai and Lanai flights.  

The problem goes beyond airline scarcity and unreliability. Also to blame is a statewide doctor shortage, a consequence of Hawaii’s high cost of living and limited medical training opportunities.

On Wednesday, as federal policy advisors made their way across Molokai from Kaunakakai to Kalaupapa, they heard residents recount tales of how their access to doctors had been undermined by airline unreliability and too few on-island medical providers. 

The group included Krystal Kaai, executive director of the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders, which convened the meetings in Honolulu Thursday and Friday.

Also on the Molokai tour was Nani Coloretti, deputy director of the White House Office of Management and Budget, and Marvin Figueroa, director of the Office of Intergovernmental and External Affairs at the U.S. Department of Health and Human Services.

One of the tour stops was Molokai Community Health Center, the island’s federally qualified health center. The clinic offers medical, dental and behavioral health care as well as social services, regardless of patients’ ability to pay.

Hawaii Congresswoman Jill Tokuda (David Croxford/Civil Beat/2023)

Of the clinic’s five medical providers, only one — a licensed marriage and family therapist — lives on Molokai. All of its doctors and its dentist either commute from other islands or are temporarily based on Molokai to fill gaps in care. 

“They definitely got the message loud and clear that this is a problem,” Tokuda said. “I wish there was an easy answer. But half the battle is just getting across that this is not acceptable. And I think the entire group concluded that what communities like Molokai are facing in terms of transportation right now is just not acceptable.”

Whether the government leaders will be able to translate that sentiment into action remains to be seen. 

Last month Tokuda and Texas Rep. Diana Harshbarger relaunched the Congressional Bipartisan Rural Health Caucus, an advocacy forum that disbanded in 2010. The caucus will host briefings and events to educate lawmakers and the public about potential policy solutions, including stemming hospital closures, ensuring fair reimbursement rates, strengthening the health care workforce, reducing health inequities and expanding telehealth access.

Tokuda said she’s also been pursuing a face-to-face meeting with executives from Southern Airways, the parent company of Mokulele Airlines, to discuss the need for more reliable flight service.

Civil Beat’s coverage of Maui County is supported in part by a grant from the Nuestro Futuro Foundation.

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