HCR 23: requesting the auditor to assess the social and financial effects of mandatory health insurance coverage for prosthetic devices and orthotic devices.

HOUSE OF REPRESENTATIVES	H.C.R. NO.	23
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

 

 

requesting the auditor to assess the social and financial effects of mandatory health insurance coverage for prosthetic devices and orthotic devices.

 

 

 

     WHEREAS, prosthetic devices and orthotic devices play a vital role in restoring mobility, independence, and functionality for individuals with limb loss or limb difference or who require support for musculoskeletal impairments; and

 

     WHEREAS, there are more than 18,000 Hawaii residents living with limb loss, limb difference, and mobility impairments who face significant barriers to participating in physical activities and recreational opportunities and performing activities of daily living due to outdated and discriminatory insurance coverage and policies that routinely deny access to essential activity-specific prostheses; and

 

     WHEREAS, individuals with limb loss and limb differences in Hawaii must often rely on a single prosthetic device, which is typically designed for limited mobility and does not accommodate activities such as running, cycling, swimming, or bathing, creating unnecessary risks of injury, preventable health conditions, and diminished quality of life; and

 

     WHEREAS, the denial of coverage for activity-specific prostheses perpetuates inequities in health, independence, and economic opportunity for individuals with disabilities in Hawaii, forcing many to bear prohibitive out-of-pocket costs or forgo these necessary tools entirely; and

 

     WHEREAS, comprehensive insurance coverage for prosthetic devices and orthotic devices is critical to reducing the prevalence of preventable secondary health conditions such as diabetes, cardiovascular disease, and obesity, which disproportionately affect individuals with disabilities; and

 

     WHEREAS, section 23-51, Hawaii Revised Statutes, requires that "[b]efore any legislative measure that mandates health insurance coverage for specific health services, specific diseases, or certain providers of health care services as part of individual or group health insurance policies, can be considered, there shall be concurrent resolutions passed requesting the auditor to prepare and submit to the legislature a report that assesses both the social and financial effects of the proposed mandated coverage"; and

 

     WHEREAS, section 23-51, Hawaii Revised Statutes, further provides that "[t]he concurrent resolutions shall designate a specific legislative bill that:

 

     (1)  Has been introduced in the legislature; and

 

     (2)  Includes, at a minimum, information identifying the:

 

          (A)  Specific health service, disease, or provider that would be covered;

 

          (B)  Extent of the coverage;

 

          (C)  Target groups that would be covered;

 

          (D)  Limitations on utilization, if any; and

 

          (E)  Standards of care.

 

For purposes of this part, mandated health insurance coverage shall not include mandated optionals."; and

 

     WHEREAS, section 23-52, Hawaii Revised Statutes, further specifies the minimum information required for assessing the social and financial impact of the proposed health coverage mandate in the Auditor's report; and

 

     WHEREAS, House Bill No. 1536, introduced in the Regular Session of 2026, proposes to expand existing health insurance mandates to provide coverage for the cost of prosthetic devices, including activity-specific prostheses, and orthotic devices; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2026, the Senate concurring, that the Auditor is requested to conduct an impact assessment report in accordance with sections 23-51 and 23-52, Hawaii Revised Statutes, of mandating health insurance coverage for the cost of prosthetic devices, including activity-specific prostheses, and orthotic devices, as proposed by House Bill No. 1536, introduced in the Regular Session of 2026; and

 

     BE IT FURTHER RESOLVED that the Auditor is further requested to include in its assessment the impact of section 1311(d)(3) of the federal Patient Protection and Affordable Care Act (PPACA) on House Bill No. 1536, Regular Session of 2026, that includes but is not limited to the additional cost of any benefits beyond the essential health benefits of Hawaii's qualified health plans under the PPACA; and

 

     BE IT FURTHER RESOLVED that the Auditor is requested to submit a report of the Auditor's findings and recommendations, including any proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2027; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor, Director of Commerce and Consumer Affairs, and Insurance Commissioner.

 

 

 

	OFFERED BY:	_____________________________

Report Title: 

Auditor; Impact Assessment Report; Mandatory Health Insurance Coverage; Prosthetic Devices; Orthotic Devices