STAND. COM. REP. NO. 1765-22

Honolulu, Hawaii

, 2022

RE: H.C.R. No. 28

H.D. 1

Honorable Scott K. Saiki

Speaker, House of Representatives

Thirty-First State Legislature

Regular Session of 2022

State of Hawaii

Sir:

Your Committee on Consumer Protection & Commerce, to which was referred H.C.R. No. 28 entitled:

"HOUSE CONCURRENT RESOLUTION REQUESTING THE AUDITOR TO ASSESS THE SOCIAL AND FINANCIAL EFFECTS OF MANDATORY HEALTH INSURANCE COVERAGE FOR FERTILITY PRESERVATION PROCEDURES FOR CERTAIN PERSONS WHO HAVE BEEN DIAGNOSED WITH CANCER AND WHOSE CANCER OR CANCER TREATMENT MAY ADVERSELY AFFECT THEIR FERTILITY,"

begs leave to report as follows:

The purpose of this measure is to request the Auditor to assess the social and financial effects of mandatory health insurance coverage for fertility preservation procedures for certain persons who have been diagnosed with cancer and whose cancer or cancer treatment may adversely affect their fertility.

Your Committee received testimony in support of this measure from the Hawaii Society of Clinical Oncology, Association for Clinical Oncology, Kaiser Permanente Hawai‘i, and Alliance for Fertility Preservation. Your Committee received comments on this measure from the Office of the Auditor, Hawaii Medical Service Association, and Hawaii Association of Health Plans.

Your Committee finds that for individuals with cancer, the struggles of infertility are heavily exacerbated, as they are forced to sacrifice their ability to conceive and start a family in order to survive their condition. However, due to advances in reproductive technology, cancer need not preclude parenthood. Offering techniques to preserve fertility is now recognized by all relevant medical societies as a standard part of cancer care, but access remains a challenge.

Your Committee further finds that mandated health insurance coverage for fertility preservation procedures is not generally covered by health insurance and would be considered a new mandated benefit. This measure therefore requests the Auditor to conduct an impact assessment report on the social and financial effects of the mandated health insurance coverage for fertility preservation procedures for certain persons who have been diagnosed with cancer proposed by House Bill No. 2242 and Senate Bill No. 3308, Regular Session of 2022.

Your Committee has amended this measure by:

(1) Expanding the contents of the impact assessment report to include:

(A) A survey of other states that have implemented mandated health insurance coverage for cryopreservation procedures;

(B) Various areas of research, including whether the proposed mandated coverage would trigger the State's defrayal of excess costs, a standard medical definition of reproductive age, and any standards of coverage currently used by public and private health care entities;

(C) Various topics for further examination, such as medically necessary standards of care, technology related to infertility procedures, current scientific studies and medical literature, and appropriate scope of coverage; and

(D) Consideration of certain questions relating to the ethical and legal issues surrounding the rights and entitlements to cryopreserved material; and

(2) Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.

As affirmed by the record of votes of the members of your Committee on Consumer Protection & Commerce that is attached to this report, your Committee concurs with the intent and purpose of H.C.R. No. 28, as amended herein, and recommends its adoption in the form attached hereto as H.C.R. No. 28, H.D. 1.

Respectfully submitted on behalf of the members of the Committee on Consumer Protection & Commerce,

____________________________

AARON LING JOHANSON, Chair