New Charter Flights Bring Critical Medical Access to Moloka‘i and Lana‘i

Boarding an airplane is routine for rural Hawai‘i residents seeking medical care. However, fewer airlines now serve Moloka‘i and Lana‘i residents. This has caused frequent flight disruptions and missed appointments. Some residents now skip necessary medical visits entirely.

State lawmakers funded a $2 million pilot project in 2024. This project is the Essential Rural Medical Air Transport (ERMAT) program. It aims to provide a new link to the Honolulu medical hub. The program charters flights for patients with off-island appointments. It also flies Honolulu doctors to the neighbor islands for care.

The ERMAT Pilot Program

Patients need a primary care physician referral for a seat. This secures an expenses-paid charter flight to Honolulu or Maui. The program is run by Pūlama Ka Heke and Lānaʻi Kinaole. Lani Ozaki, a program executive, called it a "game changer." Ozaki noted that many older residents had simply given up on specialist appointments.

The first nine-seat charter flight is set for this month. Pacific Air Charters operation will fly from Moloka‘i’s Ho‘olehua Airport. Flights from Lānaʻi are scheduled to begin in February. The program aims to serve 1,500 Moloka‘i residents monthly. It also targets 1,000 Lana‘i residents on a weekly charter in 2026. The program may also cover costs on Mokulele Airlines or the ferry.

Aviation Challenges and Reliability

Unreliable commercial service is the core problem. Mokulele Airlines flight disruptions have left patients stranded. One Moloka‘i patient waited three weeks for surgery. The patient had broken ankles and heels. ERMAT secured a seat on a fully booked Mokulele flight. In another case, a kidney transplant patient needed urgent transport. Commercial flights were booked for days. ERMAT coordinators quickly arranged a charter flight. This early test secured the life-saving transplant.

Charter flights cost roughly double a Mokulele roundtrip ticket. The program is funded only through the end of the year. State Senator Joy San Buenaventura seeks more funding for 2027. This is needed if the charter flights prove successful.

Pacific Air Charters uses a nine-seat aircraft. This aircraft cannot accommodate wheelchair-bound passengers. This is a current limitation of the program. However, the charter offers a more reliable flight schedule. This reliability may entice more doctors to travel to Moloka‘i. Physicians can use the service for a discounted $200 roundtrip rate.

Broader Rural Health Care Access

Lack of reliable transport is only one issue. Hawai‘i physician workforce shortage is also severe. The state needs 23% more doctors overall. Moloka‘i alone needs an 83% increase in physicians. Low reimbursement rates for government insurance make recruitment difficult.

In a major development, Hawai‘i received significant federal funding. The state was awarded nearly $189 million. This came from the Centers for Medicare & Medicaid Services' (CMS) Rural Health Transformation Program. This is part of a $50 billion national investment. Hawai‘i's award is one of the largest per capita. The funds cover the first year of a five-year strategy. Additional annual awards are expected through 2030.

This funding will support several initiatives. The goal is to reduce the need to fly to O‘ahu. Plans include expanding medical clinics and stabilizing hospitals. The funds will also train and recruit new healthcare providers. This combined approach addresses both access and workforce gaps. The ERMAT program offers an immediate, air-based solution. The federal grant provides a long-term infrastructure plan.

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