The state's two largest health insurers suffered substantial losses in the first quarter and they are blaming Obamacare. Hawaii Medical Service Association racked up $46.1 million in costs due to the Affordable Care Act, which contributed to a $30.1 million dollar loss after investment gains from January to March. Kaiser Permanente Hawaii said the federal law added approximately $8 million in first-quarter expenses, resulting in a $5.8 million loss. The insurers say members will feel the pinch with higher premium rates. HMSA says costs related to Obamacare are the main reason for a $12.8 percent proposed rate hike for most of the 77,000 small-business workers renewing health plans July 1. Kaiser said ACA fees account for approximately 2% to 3% of insurance premium costs.