STAND. COM. REP. NO. 1068-26

Honolulu, Hawaii

, 2026

RE: H.B. No. 1864

H.D. 2

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2026

State of Hawaii

Madame:

Your Committee on Consumer Protection & Commerce, to which was referred H.B. No. 1864, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO INSURANCE,"

begs leave to report as follows:

The purpose of this measure is to, beginning after December 31, 2026, require insurers, mutual benefit societies, and health maintenance organizations to provide coverage for standard fertility preservation services for persons undergoing medically necessary treatment that may cause iatrogenic infertility.

Your Committee received testimony in support of this measure from the Department of Commerce and Consumer Affairs; Department of Health; State Health Planning and Development Agency; Facing Our Risk of Cancer Empowered; Hawaii Society of Clinical Oncology; Association for Clinical Oncology; Fertility Institute of Hawaii; Advanced Reproductive Medicine & Gynecology of Hawaii, Inc.; Blood Cancer United; America Cancer Society Cancer Action Network; Hawaii Association of Health Plans; Hawaii Medical Service Association; Alliance for Fertility Preservation; Oncology Nursing Society; Hawaiʻi Women Lawyers; and nine individuals.

Your Committee finds that some cancer treatments can cause iatrogenic infertility when chemotherapy, radiation, and surgery damage reproductive cells, reproductive organs, or endocrine functioning. These treatments can also adversely impact the ability to carry a pregnancy. Although patients facing iatrogenic infertility have recognized, effective options for preserving fertility, the high cost of these procedures and the narrow window to obtain services means these procedures are unattainable for many people. This measure assists in the offsetting of those costs by mandating coverage for standard fertility preservation services.

Your Committee has amended this measure by:

(1) Requiring insurers, mutual benefit societies, and health maintenance organizations to base clinical guidelines on the 2018 update to the American Society of Clinical Oncology guidelines, rather than the most recent guidelines;

(2) Clarifying that, for purposes of health maintenance organizations, the mandated coverage under this measure applies after December 31, 2026, rather than on or after; and

(3) 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 is in accord with the intent and purpose of H.B. No. 1864, H.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 1864, H.D. 2.

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

____________________________

SCOT Z. MATAYOSHI, Chair