Hospitals statewide received millions of dollars in federal aid yesterday to help offset the spiraling cost of caring for Hawai'i's uninsured patients.

The money from the $24 million program is only a fraction of the annual cost, estimated at $100 million, but was greatly appreciated by hospital administrators who were handed hefty checks by Gov. Linda Lingle and Lillian Koller, director of the Department of Human Services.

Sixteen private hospitals received portions of $17.5 million. An additional $3.4 million was given to Hawai'i Health Systems Corp. to assist four public hospitals and the corporation will receive another $3.4 million in January as part of the package from the federal Centers for Medicare and Medicaid Services.

The cost of covering the uninsured has grown by $52 million in the past five years, according to the Hawai'i Healthcare Association.

"I know it is a struggle for every single hospital in the state to maintain the high quality of care that you are delivering," Lingle told the administrators.

With new money, hospitals can shift their resources to improving some of the oldest buildings and equipment in the nation, said Virginia Pressler, senior vice president for Hawai'i Pacific Health, which operates four hospitals.

"Things get put off year after year that we know need to be done, but we have to put it off in favor of patient care," she said. "And things get dingier and dingier. The risks to patients are significant by not upgrading our healthcare system. Yes, we are dodging a bullet."

This is the second year in a row that the state was able to secure federal assistance for the problem and represents something of a coup for state officials. When the state received $16 million last year, it was told it would not get any more, Koller said. Dogged negotiations in the interim, however, produced a six-year funding commitment.

"They declared it was a one-time only thing, but we continued to nag and nag, and we got it," Koller said.

It's estimated that 9.6 percent of Hawai'i residents — about 120,000 adults and children — are uninsured at any given time, according to the Hawai'i Uninsured Project. But while the percentage is small when compared to other states such as Texas, where 25 percent of residents are uninsured, the problem has the potential to overwhelm hospital functions.

For example, at Wahiawa General Hospital, half of the 14,000 emergency-room patients each year are uninsured, said Alan Ulrich, the hospital's chief financial officer.

"It's very important for us to have the funds to provide services for central O'ahu and the North Shore," he said. "It's a not-for-profit institution. Certainly having new money like this helps subsidize and support the mission of the hospital."

Reach Mike Gordon at mgordon@honoluluadvertiser.com.