HB 866: RELATING TO HEALTH CARE.

A BILL FOR AN ACT

RELATING TO HEALTH CARE.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that the people of Hawaii have a long tradition of protecting an individual's right to privacy and bodily autonomy independently of, and more broadly than, the federal constitution.  In 1970, the State became the first state in the nation to legalize abortion with the enactment of Act 1, Session Laws of Hawaii 1970.  In 1978, the 1978 Hawaii State Constitutional Convention proposed, and the electorate approved, an amendment to explicitly codify the right to privacy in article I, section 6, of the Hawaii State Constitution.  In 2006, the legislature took one of its constitutionally required affirmative steps to implement the right to privacy by passing Act 35, Session Laws of Hawaii 2006, which established that the State shall not deny or interfere with a pregnant person's right to choose or obtain an abortion of a nonviable fetus or an abortion that is necessary to protect a pregnant person's life or health.  Act 35 also removed the outdated requirement that individuals who seek an abortion be a Hawaii resident for at least ninety days.

     However, the legislature further finds that existing developments in the legal landscape threaten the State's policy to protect an individual's right to privacy and personal autonomy over one's body within state boundaries.  In June 2022, the Supreme Court of the United States held in Dobbs v. Jackson Women's Health Organization, 142 S.Ct. 2228 (2022), that the United States Constitution does not confer a right to an abortion.  Dobbs overrules Roe v. Wade, 410 U.S. 113 (1973), and Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833 (1992), and the nearly fifty years of federal precedent regarding reproductive rights.  The impact of Dobbs has resulted in many states either banning or severely restricting access to abortion.  Additionally, some states are pursuing laws or policies purporting to impose civil or criminal liability or professional discipline in connection with the provision or receipt of, or assistance with, reproductive health care services outside of these states' borders.

     It is the policy of this State that the rights of equality, liberty, and privacy guaranteed under article I, sections 3, 5, and 6, of the Hawaii State Constitution are fundamental rights and that those rights include an individual's right to make reproductive health care decisions about one's own body and to decide whether to bear a child or obtain an abortion.  Due to the shifting legal landscape regarding the right to privacy and an individual's bodily autonomy, the legislature finds it is imperative to reiterate and bolster the State's policy to affirm protection of these rights and freedoms within the state boundaries.

     The legislature finds that in-person abortion care is only available on Maui and Oahu.  Furthermore, sixty-three per cent of abortions are accomplished with the administration of oral medication.  Two medications are commonly used for abortion: misoprostol and mifepristone.  If the Federal Food and Drug Administration changes approved indications for these medications, the mifepristone supply chain may suffer temporary disruption.

     Given those possibilities, the State has a responsibility to uphold civil and reproductive rights and may choose to stockpile medication required to facilitate maintaining the status quo on reproductive rights.  Other states have adopted laws or implemented policies to stockpile abortifacient medications, including California (to stockpile two hundred fifty thousand doses, New York (to stockpile one hundred fifty thousand doses), Massachusetts, and Washington.

     The department of health has stockpiled abortifacient medications in the past and can do so again.  Mifepristone has a five-year shelf life.

     Accordingly, the purpose of this Act is to bolster the State's policy to protect the right to privacy and bodily autonomy within the boundaries of the State for all individuals, including minors by requiring, and appropriating funds for, the department of health to coordinate the stockpiling of mifepristone in no less than a one-year supply.

     SECTION 2.  The department of health shall coordinate the stockpiling of mifepristone, in quantities as determined by the department of health that is not less than a one-year supply statewide.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $75,000 or so much thereof as may be necessary for fiscal year 2025-2026 for the purchase of mifepristone.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 3000.

Report Title:

DOH; Reproductive Health Care; Mifepristone; Stockpile

Description:

Requires the Department of Health to coordinate the stockpiling of no less than a one-year supply of mifepristone.  Appropriates funds.  Effective 7/1/3000.  (HD1)

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

A BILL FOR AN ACT

RELATING TO HEALTH CARE.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that the people of Hawaii have a long tradition of protecting an individual's right to privacy and bodily autonomy independently of, and more broadly than, the federal constitution.  In 1970, the State became the first state in the nation to legalize abortion with the enactment of Act 1, Session Laws of Hawaii 1970.  In 1978, the 1978 Hawaii State Constitutional Convention proposed, and the electorate approved, an amendment to explicitly codify the right to privacy in article I, section 6, of the Hawaii State Constitution.  In 2006, the legislature took one of its constitutionally required affirmative steps to implement the right to privacy by passing Act 35, Session Laws of Hawaii 2006, which established that the State shall not deny or interfere with a pregnant person's right to choose or obtain an abortion of a nonviable fetus or an abortion that is necessary to protect a pregnant person's life or health.  Act 35 also removed the outdated requirement that individuals who seek an abortion be a Hawaii resident for at least ninety days.

     However, the legislature further finds that existing developments in the legal landscape threaten the State's policy to protect an individual's right to privacy and personal autonomy over one's body within state boundaries.  In June 2022, the Supreme Court of the United States held in Dobbs v. Jackson Women's Health Organization, 142 S.Ct. 2228 (2022), that the United States Constitution does not confer a right to an abortion.  Dobbs overrules Roe v. Wade, 410 U.S. 113 (1973), and Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833 (1992), and the nearly fifty years of federal precedent regarding reproductive rights.  The impact of Dobbs has resulted in many states either banning or severely restricting access to abortion.  Additionally, some states are pursuing laws or policies purporting to impose civil or criminal liability or professional discipline in connection with the provision or receipt of, or assistance with, reproductive health care services outside of these states' borders.

     It is the policy of this State that the rights of equality, liberty, and privacy guaranteed under article I, sections 3, 5, and 6, of the Hawaii State Constitution are fundamental rights and that those rights include an individual's right to make reproductive health care decisions about one's own body and to decide whether to bear a child or obtain an abortion.  Due to the shifting legal landscape regarding the right to privacy and an individual's bodily autonomy, the legislature finds it is imperative to reiterate and bolster the State's policy to affirm protection of these rights and freedoms within the state boundaries.

     The purpose of this Act is to bolster the State's policy to protect the right to privacy and bodily autonomy within the boundaries of the State for all individuals, including minors.  In-person abortion care is only available on Maui and Oahu.  Furthermore, sixty-three per cent of abortions are accomplished with the administration of oral medication.

     Two medications are commonly used for abortion: misoprostol and mifepristone.  The Federal Drug Administration may change approved indications for these medications and the mifepristone supply chain may suffer temporary disruption.

     Given those possibilities, the State has a responsibility to uphold civil and reproductive rights and may choose to stockpile medication required to facilitate maintaining the status quo on reproductive rights.  Other states have adopted laws or implemented policies to stockpile abortifacient medications, including California (to stockpile two hundred fifty thousand doses, New York (to stockpile one hundred fifty thousand doses), Massachusetts, and Washington.

     The department of health has stockpiled abortifacient medications in the past and can do so again.  Mifepristone has a five-year shelf life.  This Act requires the department of health to stockpile a one-year supply of mifepristone (approximately one thousand doses) by working with one or more local pharmacies.  This Act appropriates $75,000 for this purpose to be expended by the department of health.

     SECTION 2.  The department of health shall purchase and store a one-year supply of mifepristone, as determined by the department of health.  The department of health shall coordinate with one or more pharmacies located in the State to purchase the supply.

     SECTION 3.  There is appropriated out of the general revenues of the State of Hawaii the sum of $75,000 or so much thereof as may be necessary for fiscal year 2025-2026 for the purchase of a one-year supply of mifepristone.

     The sum appropriated shall be expended by the department of health for the purposes of this Act.

     SECTION 4.  This Act shall take effect on July 1, 2025.

Report Title:

DOH; Reproductive Health Care; Mifepristone; Stockpile

Description:

Directs the Department of Health to purchase and store a 1 year supply of mifepristone by working with 1 or more pharmacies in the State.  Appropriates moneys.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.

STAND. COM. REP. NO.  451

Honolulu, Hawaii

                , 2025

RE:   H.B. No. 866

      H.D. 1

Honorable Nadine K. Nakamura

Speaker, House of Representatives

Thirty-Third State Legislature

Regular Session of 2025

State of Hawaii

Madame:

     Your Committee on Health, to which was referred H.B. No. 866 entitled:

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

begs leave to report as follows:

     The purpose of this measure is to require, and appropriate funds for, the Department of Health to stockpile a one-year supply of mifepristone.  

     Your Committee received testimony in support of this measure from one member of the Hawaiʻi County Council; AAUW of Hawaii; Democratic Party of Hawaiʻi; Indivisible Hawaiʻi; Democratic Party of Hawaiʻi Women's Caucus; American College of Obstetricians and Gynecologists; Democratic Party of Hawaiʻi Education Caucus; Hawaiʻi Public Health Institute; Fujiwara & Rosenbaum LLLC; and numerous individuals.  Your Committee received testimony in opposition to this measure from five individuals.  Your Committee received comments on this measure from the Department of Health.

     Your Committee finds that developments in the nation's legal landscape threaten the reproductive health care rights of people in Hawaii.  Legislative efforts and legal challenges from anti-abortion State lawmakers on the mainland could lead to nationwide restrictions and potential federal actions could be used to ban mifepristone throughout the country.  Your Committee further finds that by stockpiling mifepristone, the State ensures continued access to medication-based abortions, especially given limited in-person services and potential supply chain disruptions.  This measure reinforces the State's longstanding commitment to privacy, bodily autonomy, and reproductive rights.

     Your Committee notes the appropriation amount of $75,000 in this measure for the purchase of mifepristone and respectfully requests the Department of Health to develop a storage and distribution plan, particularly for neighbor islands.

     Your Committee has amended this measure by:

     (1)  Providing the Department of Health with the flexibility to coordinate the stockpiling of mifepristone in quantities no less than a one-year supply;

     (2)  Changing the effective date to July 1, 3000, to encourage further discussion; 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 Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 866, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 866, H.D. 1, and be referred to your Committee on Finance.

Respectfully submitted on behalf of the members of the Committee on Health,