SB 642: Insurance; Mandatory Optional Coverage; Standard Fertility Preservation Services; Medically Necessary Treatment
- Session Year: 2025-2026
- House: Senate
- Latest Version Date: 2025-02-28
Current Status:
Failed
(2025-12-08: Carried over to 2026 Regular Session.)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Final Decking
Enacted
Requires all health insurance policies, contracts, plans, and agreements issued or renewed after 12/31/2025, to provide optional coverage for standard fertility preservation services for persons undergoing medically necessary cancer-related treatments that may cause iatrogenic infertility. Effective 12/31/2050. (SD2)
Requires all health insurance policies, contracts, plans, and agreements issued or renewed after 12/31/2025, to provide optional coverage for standard fertility preservation services for persons undergoing medically necessary treatment that may cause iatrogenic infertility. Effective 12/31/2050. (SD1)
For policies, contracts, plans, and agreements issued or renewed after 12/31/2025, requires the 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.
|
THE SENATE |
S.B. NO. |
642 |
|
THIRTY-THIRD LEGISLATURE, 2025 |
S.D. 2 |
|
|
STATE OF HAWAII |
|
|
|
|
|
|
|
|
||
|
|
||
A BILL FOR AN ACT
RELATING TO INSURANCE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A, part I, to be appropriately designated and to read as follows:
"§431:10A- Standard fertility preservation services; optional coverage. (a) Each policy of individual or group accident and health or sickness insurance issued or renewed in the State after December 31, 2025, shall provide to the policyholder optional coverage for standard fertility preservation services for any insured who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.
(b) No policy that provides optional coverage for standard fertility preservation services as required by subsection (a) shall:
(1) Use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of the required optional coverage; or
(2) Discriminate based on the insured's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions.
(c) Any limitations imposed by a policy shall be based on the covered individual's medical history and clinical guidelines adopted by the insurer. Any clinical guidelines used by the insurer shall be based on the 2018 update to the guidelines developed by the American Society of Clinical Oncology and shall not deviate from the full scope of the guidelines.
(d) For the purposes of this section:
"Iatrogenic infertility" means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes.
"Medically necessary treatment that may directly or indirectly cause iatrogenic infertility" means any cancer‑related medical treatment with a likely side effect of infertility.
"Standard fertility preservation services" means the procedures to preserve fertility as outlined and established according to the 2018 update to the professional guidelines published by the American Society of Clinical Oncology. "Standard fertility preservation services" include the full scope of services or treatments, without any exclusions or limitations, as defined in the 2018 update to the professional guidelines established by the American Society of Clinical Oncology. "Standard fertility preservation services" do not include:
(1) Any experimental procedures or other procedures not determined to be established medical practices according to the 2018 update to the guidelines developed by the American Society of Clinical Oncology;
(2) Third-party assisted reproduction technology procedures, including donor eggs or surrogates and gestational carriers; and
(3) Any services relating to cryopreservation storage."
SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article 1, part VI, to be appropriately designated and to read as follows:
"§432:1- Standard fertility preservation services; optional coverage. (a) Each individual or group hospital or medical service plan contract issued or renewed in this State after December 31, 2025, shall provide to the member optional coverage for standard fertility preservation services for any covered person who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.
(b) No plan contract that provides optional coverage for standard fertility preservation services as required by subsection (a) shall:
(1) Use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of the required optional coverage; or
(2) Discriminate based on the covered person's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions.
(c) Any limitations imposed by a plan contract shall be based on the covered individual's medical history and clinical guidelines adopted by the mutual benefit society. Any clinical guidelines used by the mutual benefit society shall be based on the 2018 update to the guidelines developed by the American Society of Clinical Oncology and shall not deviate from the full scope of the guidelines.
(d) For the purposes of this section:
"Iatrogenic infertility" means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes.
"Medically necessary treatment that may directly or indirectly cause iatrogenic infertility" means any cancer‑related medical treatment with a likely side effect of infertility.
"Standard fertility preservation services" means the procedures to preserve fertility as outlined and established according to the 2018 update to the professional guidelines published by the American Society of Clinical Oncology. "Standard fertility preservation services" include the full scope of services or treatments, without any exclusions or limitations, as defined in the 2018 update to the professional guidelines established by the American Society of Clinical Oncology. "Standard fertility preservation services" do not include:
(1) Any experimental procedures or other procedures not determined to be established medical practices according to the 2018 update to the guidelines developed by the American Society of Clinical Oncology;
(2) Third-party assisted reproduction technology procedures, including donor eggs or surrogates and gestational carriers; and
(3) Any services relating to cryopreservation storage."
SECTION 3. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23
Required provisions and benefits. Notwithstanding any provision of law to the
contrary, each policy, contract, plan, or agreement issued in the State after
January 1, 1995, by health maintenance organizations pursuant to this chapter,
shall include benefits provided in sections 431:10-212, 431:10A-115,
431:10A-115.5, 431:10A-116, 431:10A‑116.2, 431:10A-116.5, 431:10A-116.6,
431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126,
431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, and [431:10A-134,]
431:10A- , and chapter 431M."
SECTION 4. The benefit to be provided by health maintenance organizations corresponding to the benefit provided under section 431:10A- , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 3 of this Act, shall take effect for all policies, contracts, plans, or agreements issued or renewed in the State after December 31, 2025.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on December 31, 2050.
Report Title:
Insurance; Mandatory Optional Coverage; Standard Fertility Preservation Services; Medically Necessary Treatment
Description:
Requires all health insurance policies, contracts, plans, and agreements issued or renewed after 12/31/2025, to provide optional coverage for standard fertility preservation services for persons undergoing medically necessary cancer-related treatments that may cause iatrogenic infertility. Effective 12/31/2050. (SD2)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
|
THE SENATE |
S.B. NO. |
642 |
|
THIRTY-THIRD LEGISLATURE, 2025 |
S.D. 1 |
|
|
STATE OF HAWAII |
|
|
|
|
|
|
|
|
||
|
|
||
A BILL FOR AN ACT
RELATING TO INSURANCE.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A, part I, to be appropriately designated and to read as follows:
"§431:10A- Standard fertility preservation services; optional coverage. (a) Each individual or group policy of accident and health or sickness insurance policy issued or renewed in the State after December 31, 2025, shall provide to the policyholder optional coverage for standard fertility preservation services for any insured who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.
(b) No policy that provides optional coverage for standard fertility preservation services as required by subsection (a) shall:
(1) Use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of the required optional coverage; or
(2) Discriminate based on the insured's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions.
(c) Any limitations imposed by a policy shall be based on the covered individual's medical history and clinical guidelines adopted by the insurer. Any clinical guidelines used by the insurer shall be based on the current guidelines developed by the American Society of Clinical Oncology and shall not deviate from the full scope of the guidelines.
(d) For the purposes of this section:
"Iatrogenic infertility" means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes.
"Medically necessary treatment that may directly or indirectly cause iatrogenic infertility" means medical treatment with a likely side effect of infertility as established by the American Society of Clinical Oncology.
"Standard fertility preservation services" means the procedures to preserve fertility as outlined and established according to the professional guidelines published by the American Society of Clinical Oncology. "Standard fertility preservation services" include the full scope of services or treatments, without any exclusions or limitations, as defined in the most recent professional guidelines established by the American Society of Clinical Oncology. "Standard fertility preservation services" do not include:
(1) Any experimental procedures or other procedures not determined to be established medical practices by the American Society of Clinical Oncology;
(2) Third-party assisted reproduction technology procedures, including donor egg or surrogates and gestational carriers; and
(3) Any services relating to cryopreservation storage."
SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article 1, part VI, to be appropriately designated and to read as follows:
"§432:1- Standard fertility preservation services; optional coverage. (a) Each individual or group hospital or medical service plan contract issued or renewed in this State after December 31, 2025, shall provide to the member optional coverage for standard fertility preservation services for any covered person who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.
(b) No plan contract that provides optional coverage for standard fertility preservation services as required by subsection (a) shall:
(1) Use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of the required optional coverage; or
(2) Discriminate based on the covered person's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions.
(c) Any limitations imposed by a plan contract shall be based on the covered individual's medical history and clinical guidelines adopted by the mutual benefit society. Any clinical guidelines used by the mutual benefit society shall be based on the current guidelines developed by the American Society of Clinical Oncology and shall not deviate from the full scope of the guidelines.
(d) For the purposes of this section:
"Iatrogenic infertility" means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes.
"Medically necessary treatment that may directly or indirectly cause iatrogenic infertility" means medical treatment with a likely side effect of infertility as established by the American Society of Clinical Oncology.
"Standard fertility preservation services" means the procedures to preserve fertility as outlined and established according to the professional guidelines published by the American Society of Clinical Oncology. "Standard fertility preservation services" include the full scope of services or treatments, without any exclusions or limitations, as defined in the most recent professional guidelines established by the American Society of Clinical Oncology. "Standard fertility preservation services" do not include:
(1) Any experimental procedures or other procedures not determined to be established medical practices by the American Society of Clinical Oncology;
(2) Third-party assisted reproduction technology procedures, including donor egg or surrogates and gestational carriers; and
(3) Any services relating to cryopreservation storage."
SECTION 3. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23
Required provisions and benefits. Notwithstanding any provision of law to the
contrary, each policy, contract, plan, or agreement issued in the State after
January 1, 1995, by health maintenance organizations pursuant to this chapter,
shall include benefits provided in sections 431:10-212, 431:10A-115,
431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6,
431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126,
431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, and [431:10A-134,]
431:10A- , and chapter 431M."
SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 5. This Act shall take effect on December 31, 2050.
Report Title:
Insurance; Mandatory Optional coverage; Standard Fertility Preservation Services; Medically Necessary Treatment
Description:
Requires all health insurance policies, contracts, plans, and agreements issued or renewed after 12/31/2025, to provide optional coverage for standard fertility preservation services for persons undergoing medically necessary treatment that may cause iatrogenic infertility. Effective 12/31/2050. (SD1)
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
|
THE SENATE |
S.B. NO. |
642 |
|
THIRTY-THIRD LEGISLATURE, 2025 |
|
|
|
STATE OF HAWAII |
|
|
|
|
|
|
|
|
||
|
|
||
A BILL FOR AN ACT
relating to insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
SECTION 1. Chapter 431 Hawaii Revised Statutes, is amended by adding a new section to article 10A, part I, to be appropriately designated and to read as follows:
"§431:10A- Standard fertility preservation services coverage. (a) Each individual or group policy of accident and health or sickness insurance issued or renewed in the State after December 31, 2025, shall provide to the policyholder, and individuals under twenty-six years of age covered under the policy, coverage for standard fertility preservation services for any insured who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.
(b) No policy that provides coverage for standard fertility preservation services as required by subsection (a) shall:
(1) Use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of the required coverage; or
(2) Discriminate based on the insured's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions.
(c) Any limitations imposed by a policy shall be based on the covered individual's medical history and clinical guidelines adopted by the insurer. Any clinical guidelines used by the insurer shall be based on the current guidelines developed by the American Society of Clinical Oncology and shall not deviate from the full scope of the guidelines.
(d) As used in this section, unless the context requires otherwise:
"Iatrogenic infertility" means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes.
"Medically necessary treatment that may directly or indirectly cause iatrogenic infertility" means medical treatment with a likely side effect of infertility as established by the American Society of Clinical Oncology.
"Standard fertility preservation services" means the procedures to preserve fertility as outlined and established according to the professional guidelines published by the American Society of Clinical Oncology. "Standard fertility preservation services" include the full scope of services or treatments, without any exclusions or limitations, as defined in the most recent professional guidelines established by the American Society of Oncology. "Standard fertility preservation services" do not include:
(1) Any experimental procedures or other procedures not determined to be established medical practices by the American Society of Clinical Oncology;
(2) Third party assisted reproduction technology procedures, including donor egg or surrogates and gestational carriers; and
(3) Any services relating to cryopreservation storage."
SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article I, part VI, to be appropriately designated and to read as follows:
"§432:1- Standard fertility preservation services coverage. (a) Each individual or group hospital or medical service plan contract issued or renewed in this State after December 31, 2025, shall provide to the member, and individuals under twenty-six years of age covered under the plan contract, coverage for standard fertility preservation services for any covered person who may undergo a medically necessary treatment that may directly or indirectly cause iatrogenic infertility.
(b) No plan contract that provides coverage for standard fertility preservation services as required by subsection (a) shall:
(1) Use any prior diagnosis or prior fertility treatment as a basis for excluding, limiting, or otherwise restricting the availability of the required coverage; or
(2) Discriminate based on the covered person's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions.
(c) Any limitations imposed by a plan contract shall be based on the covered individual's medical history and clinical guidelines adopted by the mutual benefit society. Any clinical guidelines used by the mutual benefit society shall be based on the current guidelines developed by the American Society of Clinical Oncology and shall not deviate from the full scope of the guidelines.
(d) As used in this section, unless the context requires otherwise:
"Iatrogenic infertility" means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes.
"Medically necessary treatment that may directly or indirectly cause iatrogenic infertility" means medical treatment with a likely side effect of infertility as established by the American Society of Clinical Oncology.
"Standard fertility preservation services" means the procedures to preserve fertility as outlined and established according to the professional guidelines published by the American Society of Clinical Oncology. "Standard fertility preservation services" include the full scope of services or treatments, without any exclusions or limitations, as defined in the most recent professional guidelines established by the American Society of Oncology. "Standard fertility preservation services" do not include:
(1) Any experimental procedures or other procedures not determined to be established medical practices by the American Society of Clinical Oncology;
(2) Third party assisted reproduction technology procedures, including donor egg or surrogates and gestational carriers; and
(3) Any services relating to cryopreservation storage."
SECTION 3. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23 Required provisions and benefits. Notwithstanding any provision of law to the
contrary, each policy, contract, plan, or agreement issued in the State after
January 1, 1995, by health maintenance organizations pursuant to this chapter,
shall include benefits provided in sections 431:10-212, 431:10A-115,
431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6,
431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126,
431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, and [431:10A-134,]
431:10A- , and chapter 431M."
SECTION 4. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 5. This Act shall take effect upon its approval.
|
INTRODUCED BY: |
_____________________________ |
|
|
|
Report Title:
Insurance; Mandatory Coverage; Standard Fertility Preservation Services; Medically Necessary Treatment
Description:
For policies, contracts, plans, and agreements issued or renewed after 12/31/2025, requires the 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.
The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.
|
Date
|
Status
|
|---|---|
| Dec 8, 2025 | Carried over to 2026 Regular Session. |
| Mar 7, 2025 | This measure has been deleted from the meeting scheduled on Wednesday 03-12-25 9:00AM in conference room 329 VIA VIDEOCONFERENCE. |
| Mar 7, 2025 | Bill scheduled to be heard by HLT on Wednesday, 03-12-25 9:00AM in House conference room 329 VIA VIDEOCONFERENCE. |
| Mar 6, 2025 | Referred to HLT, CPC, FIN, referral sheet 19 |
| Mar 6, 2025 | Pass First Reading |
| Mar 4, 2025 | Received from Senate (Sen. Com. No. 180) in amended form (SD 2). |
| Mar 4, 2025 | Report adopted; Passed Third Reading, as amended (SD 2). Ayes, 25; Aye(s) with reservations: none . Noes, 0 (none). Excused, 0 (none). Transmitted to House. |
| Feb 28, 2025 | 48 Hrs. Notice 03-04-25. |
| Feb 28, 2025 | Reported from CPN/WAM (Stand. Com. Rep. No. 893) with recommendation of passage on Third Reading, as amended (SD 2). |
| Feb 26, 2025 | The committee(s) on WAM recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in WAM were as follows: 11 Aye(s): Senator(s) Dela Cruz, Moriwaki, DeCoite, Elefante, Hashimoto, Inouye, Kanuha, Kidani, Kim, Lee, C., Wakai; Aye(s) with reservations: none ; 0 No(es): none; and 2 Excused: Senator(s) Aquino, Fevella. |
| Feb 26, 2025 | The committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in CPN were as follows: 5 Aye(s): Senator(s) Keohokalole, Fukunaga, McKelvey, Richards, Awa; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none. |
| Feb 20, 2025 | The committee(s) on CPN/WAM will hold a public decision making on 02-26-25 10:00AM; Conference Room 211 & Videoconference. |
| Feb 10, 2025 | Report adopted; Passed Second Reading, as amended (SD 1) and referred to CPN/WAM. |
| Feb 10, 2025 | Reported from HHS (Stand. Com. Rep. No. 120) with recommendation of passage on Second Reading, as amended (SD 1) and referral to CPN/WAM. |
| Jan 29, 2025 | The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 5 Aye(s): Senator(s) San Buenaventura, Aquino, Hashimoto, Keohokalole, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none. |
| Jan 24, 2025 | The committee(s) on HHS has scheduled a public hearing on 01-29-25 1:00PM; Conference Room 225 & Videoconference. |
| Jan 23, 2025 | Referred to HHS, CPN/WAM. |
| Jan 17, 2025 | Passed First Reading. |
| Jan 17, 2025 | Introduced. |
|
Date
|
Description
|
Location
|
Votes
|
|
|---|---|---|---|---|
| Mar 4, 2025 | Third Reading | Senate Floor |
Passed |
|
| Feb 26, 2025 | The committee(s) on WAM recommend(s) that the measure be PASSED, WITH AMENDMENTS | Senate Standing Committee on Ways and Means |
Passed |
|
| Feb 26, 2025 | The committee(s) on CPN recommend(s) that the measure be PASSED, WITH AMENDMENTS | Senate Standing Committee on Commerce and Consumer Protection |
Passed |
|
| Jan 29, 2025 | The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS | Senate Standing Committee on Health and Human Services |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| Advanced Reproductive Medicine & Gynecology of Hawaii, Inc. | *** Support | Feb 26, 2025 |
| Alliance for Fertility Preservation | ** Support | |
| American Cancer Society Cancer Action Network Inc. | ** Support | |
| Association for Clinical Oncology | ** Support | |
| Department of Health | *** Support | Feb 26, 2025 |
| Department of Labor and Industrial Relations | ** Support | |
| Fertility Institute of Hawaii | ** Support | |
| Hawaii Association of Health Plans | ** Support | |
| Hawaii Medical Service Association | ** Support | |
| Hawaii Medical Service Association | ** Support | |
| Hawaii Society of Clinical Oncology | ** Support | |
| Hawaiʻi Women Lawyers | ** Support | |
| Leukemia & Lymphoma Society | ** Support | |
| State Health Planning and Development Agency | ** Support |
STAND. COM. REP. NO. 893
Honolulu, Hawaii
RE: S.B. No. 642
S.D. 2
Honorable Ronald D. Kouchi
President of the Senate
Thirty-Third State Legislature
Regular Session of 2025
State of Hawaii
Sir:
Your Committees on Commerce and Consumer Protection and Ways and Means, to which was referred S.B. No. 642, S.D. 1, entitled:
"A BILL FOR AN ACT RELATING TO INSURANCE,"
beg leave to report as follows:
The purpose and intent of this measure is to require all health insurance policies issued or renewed in the State after December 31, 2025, to provide optional coverage for standard fertility preservation services for persons undergoing medically necessary treatment that may cause iatrogenic infertility.
Your Committees received testimony in support of this measure from the State Health Planning and Development Agency, Hawaiʻi Women Lawyers, Alliance for Fertility Preservation, Hawaii Society of Clinical Oncology, Association for Clinical Oncology, Leukemia & Lymphoma Society, Hawaii Medical Service Association, Fertility Institute of Hawaii, Hawaii Association of Health Plans, and five individuals.
Your Committees received comments on this measure from the Department of the Attorney General, Department of Commerce and Consumer Affairs, Kaiser Permanente, and American Cancer Society Cancer Action Network.
Your Committees find that cancer treatments and survivor rates have improved significantly due to advancements in technology and medicine. These cancer treatments, however, can often require patients to undergo numerous rounds of chemotherapy and radiation, which can cause significant damage to reproductive tissues and affect fertility in these individuals. Many individuals who require these treatments can find themselves unable to afford the cost of fertility preservation services, leaving cancer survivors without the ability to start a family. Your Committees believe that requiring health insurers to provide optional coverage for fertility preservation services for certain patients will reduce some of the long-term physical, emotional, and mental impacts of cancer on patients and their families.
Your Committees have amended this measure by:
(1) Specifying that the clinical guidelines adopted by insurers, mutual benefit societies, and health maintenance organizations, and the procedures to preserve fertility, shall be based on the 2018 update to the professional guidelines published by the American Society of Clinical Oncology;
(2) Amending the definition of "medically necessary treatment that may directly or indirectly cause iatrogenic infertility" to mean any cancer-related medical treatment with a likely side effect of infertility;
(3) Clarifying that the benefit to be provided by health maintenance organizations shall take effect for all policies, contracts, plans, or agreements issued or renewed in the State after December 31, 2025; and
(4) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.
As affirmed by the records of votes of the members of your Committees on Commerce and Consumer Protection and Ways and Means that are attached to this report, your Committees are in accord with the intent and purpose of S.B. No. 642, S.D. 1, as amended herein, and recommend that it pass Third Reading in the form attached hereto as S.B. No. 642, S.D. 2.
Respectfully submitted on behalf of the members of the Committees on Commerce and Consumer Protection and Ways and Means,
|
________________________________ DONOVAN M. DELA CRUZ, Chair |
|
________________________________ JARRETT KEOHOKALOLE, Chair |
|
|
|
|
STAND. COM. REP. NO. 120
Honolulu, Hawaii
RE: S.B. No. 642
S.D. 1
Honorable Ronald D. Kouchi
President of the Senate
Thirty-Third State Legislature
Regular Session of 2025
State of Hawaii
Sir:
Your Committee on Health and Human Services, to which was referred S.B. No. 642 entitled:
"A BILL FOR AN ACT RELATING TO INSURANCE,"
begs leave to report as follows:
The purpose and intent of this measure is to require all health insurance policies, contracts, plans, and agreements issued or renewed after December 31, 2025, 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 Labor and Industrial Relations; American Cancer Society Cancer Action Network Inc.; Hawaii Association of Health Plans; Alliance for Fertility Preservation; Advanced Reproductive Medicine and Gynecology of Hawaii, Inc.; Fertility Institute of Hawaii; The Leukemia & Lymphoma Society, Inc.; Hawaii Society of Clinical Oncology; Association for Clinical Oncology; Hawaii Medical Service Association; and seven individuals.
Your Committee received comments on this measure from the Insurance Division of the Department of Commerce and Consumer Affairs and Office of the Auditor.
Your Committee finds that health insurance coverage of fertility preservation services provides options for patients to have biological children even after medical treatment has resulted in temporary or permanent infertility. Your Committee further finds that all individuals should have equitable access to quality health care and an equal opportunity to live a full life. This measure reduces significant financial barriers for many patients in need of fertility preservation services and promotes public health equity.
Your Committee acknowledges the concerns raised in the Auditor's report Study of Proposed Mandatory Health Insurance Coverage for Standard Fertility Preservation Services, Report No. 23-11, November 2023, that the Auditor was unable to determine the financial impact of mandatory insurance coverage for standard fertility preservation services on the total cost of health care due to the lack of responses from health insurance carriers, and that numerous and significant assumptions had to be made to conduct the analysis. Therefore, your Committee finds that at this point, the coverage cannot be made mandatory, but optional. Your Committee further believes that the optional coverage should also be made available to individuals who are twenty-six years of age and older.
Accordingly, your Committee has amended this measure by:
(1) Requiring health insurance policies, contracts, plans, or agreements issued or renewed after December 31, 2025, to provide optional, rather than mandatory, coverage for standard fertility preservation services;
(2) Deleting language that would have limited the required health insurance coverage for standard fertility preservation services to individuals under twenty-six years of age covered under the policy of a policyholder;
(3) Inserting an effective date of December 31, 2050, to encourage further discussion; and
(4) Making technical, nonsubstantive amendments for the purposes of clarity and consistency.
As affirmed by the record of votes of the members of your Committee on Health and Human Services that is attached to this report, your Committee is in accord with the intent and purpose of S.B. No. 642, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 642, S.D. 1, and be referred to your Committees on Commerce and Consumer Protection and Ways and Means.
Respectfully submitted on behalf of the members of the Committee on Health and Human Services,
|
|
|
________________________________ JOY A. SAN BUENAVENTURA, Chair |
|
|
|
|
|
Date
|
Testimony PDF
|
|---|---|
| Feb 26, 2025 | SB642_SD1_TESTIMONY_WAM-CPN_02-26-25_.PDF |
| Jan 28, 2025 | SB642_TESTIMONY_HHS_01-29-25_.PDF |
Discussed in Hearing
5MIN
Senate Standing Committee on Health and Human Services
Bill Author
