The majority of Hawaii’s 102,000 uninsured residents are eligible for Medicaid as part of an expansion of the program under the Affordable Care Act, a study released this week by Kaiser Family Foundation shows.

Hawaii is among 25 states and Washington, D.C., expanding Medicaid coverage to residents earning up to 138 percent of the poverty level, or about $32,500 for a family of four, in 2013. Previously, Medicaid coverage was available only to those earning up to 133 percent of the poverty level. With the change, 57 percent of the uninsured in Hawaii will qualify for the government insurance program, Kaiser said.

The study found that nearly 1 in 5 — 17 percent — of the uninsured are eligible for tax credits to reduce the cost of insurance through the online state-based marketplace, the Hawaii Health Connector, created by President Barack Obama’s signature law.

Another 16 percent will not qualify for financial assistance to purchase coverage through the Connector due to their income, while 9 percent are ineligible for coverage due to their immigration status.

"Hawaii is going into health reform with a relatively low uninsured rate compared to other states because of policies put in place many years ago to extend coverage," said Rachel Garfield, senior researcher at the Kaiser Family Foundation in Washington, D.C.

"In some ways the state has a smaller challenge to tackle. On the other hand, the state is going to be challenged to really reach out to individuals because there have been coverage pathways in the state for quite some time. The state is going to have to really do some targeted outreach to bring people into the program."

The state’s 1974 Prepaid Health Care Act, requiring employers to provide medical coverage for full-time workers, is credited with driving down the uninsured population in the islands.

"When you look at the pie of the uninsured in the state, the vast majority could gain coverage once the law is implemented, so there’s great promise under the law to get that 102,000 number even lower," Garfield added.

The law requires most Americans to get health coverage or face tax penalties beginning this year. There is no enrollment deadline for Medicaid under the ACA, and residents can sign up for coverage on the Connector through March.