Out-of-pocket costs for routine dental care are in the hundreds of dollars.
One would-be tour provider said the National Park Service has revoked the application process for companies that want to reinstate tours of the isolated peninsula on Molokai.
How the suspect managed to fly from Oahu to Molokai remains unclear.
The lawsuit says body cam footage shows Nathaniel Naki was not acting in a threatening manner when he was shot to death.
But Mokulele Airlines' new parent company says interisland travelers will start to see improvements in service much sooner than that.
Ongoing cutbacks at local publications mean there are fewer watchdogs for the public's interest.
The group didn't trust Mokulele Airlines' scheduled flights, underscoring the difficulties island residents have accessing health care and other services.
Lanai and Molokai residents often must fly to Honolulu weeks before their baby's due date to be close to an urban medical center when they go into labor.
The airline has come under pressure to offer more reliable service to Molokai and Lanai.
For months the fragility of a vital air link endangered the health of people across rural Hawaii. The state is still trying to fix it.