Former congressman Ed Case and state Senate President Colleen Hanabusa are inclined to support President Obama's health care reform plan if elected to Congress, but Honolulu City Councilman Charles Djou believes the president and federal lawmakers should start over with a clean sheet.

The three candidates in the May 22 special election in urban Honolulu's 1st Congressional District discussed health care reform last night at a forum sponsored by the American College of Healthcare Executives Hawaii-Pacific chapter at the Hawaii Prince Hotel in Waikīkī.

Obama yesterday asked Congress to vote within weeks on a reform plan to expand coverage to the uninsured, contain rising medical costs and waste and reduce the federal deficit.

George Greene, president and chief executive officer of the Healthcare Association of Hawaii, last night asked the candidates if they would vote for the plan if it includes, as expected, three provisions that could benefit Hawai'i:

• $100 million over 10 years to help local hospitals treat people under Quest, the state's version of Medicaid, the federal health insurance program for the poor and disabled.

• An exemption for the state's Prepaid Health Care Act of 1974, which requires businesses to provide insurance to employees who work more than 20 hours a week.

• A study on the geographic variation of federal reimbursements under Medicare, the federal health insurance program for the elderly, which could lead to higher payments to healthcare providers in the Islands.

Case, a Democrat, said he supports all three provisions for Hawai'i as well as Obama's recent suggestions to include ideas such as expanding medical savings accounts and funding state demonstration projects on medical-malpractice insurance reform like health courts.

But he said he could not say for sure how he would vote until he sees what is in the final bill. He also said he would reject the bill if he thought it was bad for the nation, even if it contained provisions beneficial to Hawai'i.

"I would ask a couple of important questions. First of all, if not this, what is your alternative?" Case said. "Do you have an alternative? Because I don't think that the status quo is OK, at all.

"And I think that we've got to land the plane, as well as we can."

Hanabusa, a Democrat, said she also supports the provisions for Hawai'i, particularly the preservation of the Prepaid Health Care Act, a landmark that has placed Hawai'i among the leading states nationally in health care coverage.

"We shouldn't lose anything in this process," Hanabusa said.

Djou, a Republican, described the way the reform plan has evolved as "extraordinarily ugly" and said it should be rewritten without the incentives added for states to help win passage in Congress.

"If this national proposal is so good, why does Hawai'i need an exemption?" Djou said. "And if it isn't so good, well then of course you need to push some form of exemption in there.

"But, then, are you willing to stomach all the other exemptions, all the special kickbacks and favors, for all the other states that they want?"

Case and Hanabusa also said they would support the U.S. Senate moving the reform plan by reconciliation, a procedure used on budget matters that requires a majority vote for passage, instead of the supermajority needed to break a filibuster.

Djou said he opposed reconciliation because it would conflict with Obama's own goal that the reform plan achieve bipartisan support.

The special election is to fill out the remainder of former congressman Neil Abercrombie's term. Abercrombie resigned on Sunday to campaign in the Democratic primary for governor.