STAND. COM. REP. NO. 1141-26

Honolulu, Hawaii

, 2026

RE: H.B. No. 1875

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 Judiciary & Hawaiian Affairs, to which was referred H.B. No. 1875, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO HEALTH CARE,"

begs leave to report as follows:

The purpose of this measure is to:

(1) Expand the protections established under Act 2, Session Laws of Hawaii 2023, to include gender-affirming health care services, including clarifying permitted disclosures of protected health information to address changes in federal regulations;

(2) Establish protections against abusive litigation; and

(3) Prohibit medical malpractice insurers and health carriers from taking certain adverse actions against health care providers solely on the basis that the health care provider provides lawful reproductive health care services or gender-affirming care services.

Your Committee received testimony in support of this measure from the State Health Planning and Development Agency; Hawaiʻi Civil Rights Commission; Hawaiʻi State Youth Commission; Hawaii State Commission on the Status of Women; Hawaiʻi State LGBTQ+ Commission; one member of the Hawaiʻi County Council; Hawaiʻi Public Health Institute; Democratic Party of Hawaiʻi; Stonewall Caucus of the Democratic Party of Hawaiʻi; AAUW of Hawaiʻi; HOKU PAC; Pride at Work - Hawaiʻi; Rainbow Family 808; American Civil Liberties Union of Hawaiʻi; Indivisible Hawaii Healthcare Team; Hawaii Medical Association; Green Party of Hawaiʻi; Hawaiʻi Organization for Progress and Equity; PFLAG Oʻahu; Kumukahi Health + Wellness; Visibility Brigade Honolulu; District 4 of the Hawaii Democratic Party; Indivisible Leeward Oahu; American Academy of Pediatrics, Hawaiʻi Chapter; Hawaiʻi Health & Harm Reduction Center; Hawaiʻi Women's Lawyers; Planned Parenthood Alliance Advocates - Hawaiʻi; Maui Indivisible; Healthcare Association of Hawaii; American College of Obstetricians and Gynecologists, Hawaiʻi Section; Hawaii State AFL-CIO; UNITE HERE Local 5; AlohaCare; Drug Policy Forum of Hawaiʻi; Evolve Health, LLC; Utopia Hawaii; Frost Family Foundation; Essential Access Health; Hawaiʻi County Democratic Party; Lamda Law Hawaiʻi; Indivisible Oahu; and numerous individuals. Your Committee received testimony in opposition to this measure from the Hawaii Family Forum and numerous individuals. Your Committee received comments on this measure from the Department of Commerce and Consumer Affairs; Office of Information Practices; and Hawaii Medical Service Association.

Your Committee finds that efforts by other jurisdictions to investigate, penalize, or compel participation in extraterritorial proceedings related to the lawful provision of reproductive and gender-affirming health care services in the State raise serious concerns regarding due process, judicial comity, and the improper extraterritorial application of law. Your Committee further finds that the misuse of subpoenas, civil actions, and disclosure demands may undermine confidentiality protections, burden state courts, and chill the exercise of lawful rights and professional judgment. Clarifying the circumstances under which the courts, state agencies, and covered entities may decline to cooperate with extraterritorial proceedings against health care providers providing, and patients seeking, lawful health care services, and providing remedies to deter abusive litigation, is necessary to preserve judicial resources, protect patient privacy, and ensure that Hawaii law is applied consistently within this State.

Your Committee notes that the term "abusive litigation" is not intended to include potential insurance disputes over coverage status, medical necessity, fraud, waste and abuse, or the recovery of overpayments. Your Committee further notes that this measure does not expand required health care coverage of any treatments or services or create any new mandates for health insurance coverage in Hawaii.

Your Committee has amended this measure by:

(1) Inserting a preamble;

(2) Clarifying that any sanction, fine, penalty, or rate increase imposed by a malpractice insurer must be based on actuarial analysis conducted in accordance with the applicable Actuarial Standards of Practice promulgated by the Actuarial Standards Board;

(3) Amending the definition of "gender-affirming health care services"; and

(4) 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 Judiciary & Hawaiian Affairs that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 1875, H.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 1875, H.D. 2.

Respectfully submitted on behalf of the members of the Committee on Judiciary & Hawaiian Affairs,

____________________________

DAVID A. TARNAS, Chair