Durango Herald / Associated Press, August 4, 2014

Janice Nakamura knows the financial burden of going without health care, and she's thankful for the Hawaii law that strictly mandates expansive, employer-provided coverage for her and her family. Without that, "it would be a choice between paying for medical coverage or eating," she said. The Nakamuras are among the 763,000 Hawaii residents – more than half the state's population – who rely on a unique, longstanding system that has been jeopardized by the federal health-care overhaul. State officials are concerned that if they don't quickly find a solution, Hawaii will end up getting "punished for being too good," as University of Hawaii law professor Hazel Bay described.

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