Senate Standing Committee on Commerce and Consumer Protection

Calling the 09:30am calendar for the joint committee on con commerce consumer affairs and health and human services. Like to introduce my co chair, Senator Keohokalole. This meeting is being streamed live on YouTube in the unlikely event that we must abruptly end this hearing due to technical difficulties, the committee will reconvene to discuss any outstanding business later at for HHS at 01:45pm, Monday, 03/23/2026 in Room 225. And for CPM?

It'll be Tuesday, March 24 at 09:50AM in this Room 229.

And and a public notice will be posted on the legislator's website. To facilitate this hearing in a timely manner, we will be enforcing a one minute limit on testimony. I will be reading a list of individuals who submitted written testimony for each measure. We apologize if the closed captioning does not accurately transcribe the names. If you're interested in reviewing the written testimony, please go to the legislator's website.

You will find a link on the status page for the measure. We appreciate your understanding and remind you that Comey does have your testimony. We review them, so I encourage you to use your time to either add additional comments or you can stand on your written testimony. First up, we have HB 1573 relating to health—SHPDA in support.

Yes. I Hello.

Come on up.

Hello, Friday. Good morning, chairs. On behalf of the I'm Terry Vespersi, on behalf of Doctor Jack Lewin, SHPDA administrator. We're in support of HB 1573 HD three, and we strongly stand on our testimony.

Thank you.

Thank you very much. Department of Health in support.

Good morning, Chair Buenaventura and, Chair Keohokalole and, Senator Fevella. Thank you for, hearing HB1573 HD3. The Department of Health supports it, and, we thank you in that, we do promote the health of our young people especially, and we thank you for your support with Act 62 in 2023, which added e cigarettes to the tax schedule. As you know, there are continue to be 6,800 other products that are on sale, although only 41 are authorized by the FDA.

So what HB1573 HD3 would do would then provide the enforcement authority for the State Department of Health and Department of Taxation that the state currently does not have that is held by the FDA. So we thank you for the opportunity and, look forward to then, promoting our children's health.

Thank you very much. Next, the Attorney General in support. Chelsea.

Morning, chairs and members of the committee. My name is Chelsea Okamoto. I am a deputy attorney general and the unit supervisor for the Tobacco Enforcement Unit. Thank you so much for hearing this bill this morning, and thank you for your cosponsorship of this at a companion of this bill and hearing that bill as well. Our department is in strong support of this bill.

The vaping industry intentionally created products that target our youth, and the Tobacco Control Act granted the FDA the power to regulate e cigarettes and has to date only authorized 41 e cigarettes. The FDA has clearly stated that these 41 products are the only products that are allowed to be sold in The United States. Yet we see so many products that are outside of that authorization. And so over the past year, our department has made an active effort to educate retailers about this authorized list.

Just today, we email we mailed out another letter to retailers, telling them that the list has updated for two more products that are tobacco flavored. And so we've laid this groundwork, and we're just asking for the tools to enforce this list. This bill creates that directory. It creates penalties and inspection powers, and we hope that these and these penalties will then go back to help fund the enforcement efforts. So thank you again for hearing this, and we saw you pass this bill.

Thank you, Chelsea. Kevin Ramirez, Hawaii Public Health Institute in support.

Good morning, chairs, vice chair, and member of the committee. My name is Kevin Ramirez. I'm the program manager for the Coalition for the Tobacco Free Hawaii, a program of Hawaii Public Health Institute. Thank you for hearing this measure and for the opportunity to testify. I'm here to testify in support.

I've been doing, vaping prevention education in our local schools across the state for the last nine years and very well aware that our youth are dealing with a youth vaping epidemic that has now creeped into the elementary level schools. I could also tell you that the majority of the products that are driving this youth epidemic are unauthorized by the FDA. The FDA has only authorized 41 e cigarette products that are legally to be sold.

And the reason for that number being so small is they have to meet a high standard, that have to provide a benefit for the public health. So if an e cigarette is authorized by the FDA, it's appropriate for an adult smoker to switch to an e cigarette, and it's also not a product that's going to be attracted, attractive to youth. The unauthorized products that are out there are attractive to youth and are also in, have the potential of continuing adult addiction to these products.

Thank you very much.

So thank you for the opportunity to testify and support.

Thank you very much. Okay. I noticed a timer here is set for the CPN normal two minute, but I am going to be enforcing, okay, the one minute time limit, as anybody who has ever testified on health and human services or ever since I've been chair knows, okay, which is for the past almost ten years. Okay. So thank you very much.

Okay. Next, we have Holly Kessler, Hawaii Public Health Association in support. Tom Inouye, Friends of Kamalani and Lydgate Park in support. COPD Hawaii Coalition in support. Valerie Chang.

Hawaii if you hear yourself, okay, please stand up and come on up because, you're not registered if I if I go through real fast. K. Doctor Ignacio, Hawaii Medical Association in support. Nicole Lulu, Hawaii Children Action Network speaks in support. Michael Robinson, Hawaii Pacific Health in support.

At American Academy of Pediatrics, Hawaii Chapter in support. [3-12] About 12 other individuals all in support and four individuals in opposition, including Hawaii Smokers Alliance. Anybody else wishing to testify on HB 1573? Members, any questions?

Attorney general.

Okay. Senator Favella, Attorney General.

Hi. Good morning. When when this bill passed, it's a good bill, do we have enough enforcement people to go out there and enforce?

That's a great question. So right now, we currently have in our tobacco enforcement unit a set of investigators already going out to every retailer store that's on in the state. And so along with their of their duties, they've agreed to take all this enforcement responsibility to to this directory. And because the product list right now is so low, it's an easy list to enforce because it's a very small number of products that they're looking out for that are approved. So they are willing to do that along with their duties.

So, I mean, I I I guess I never see into this. So if they have if they get caught selling this thing, what is the first fine? They lose their tobacco license or whatever it is. What is the

So as the bill is outlined right now, there's civil money penalties, and there's also seizure authority in the bill. We can make a referral. Right now, we can make referrals to the Department of Taxation for license revocations. So we anticipate that would be if the bill passes, hypothetically, we anticipate that being part of it.

Okay. Thank you, chair.

Okay. Thank you very much. Any any other questions? Okay. Seeing none, moving on.

HB 1645 relating to liability. First up, we have insurance division providing comments.

Good morning Chairs, Vice Chairs, members of the committee. Matt Tsujimura on behalf of the insurance division. We'll stand on our written testimony offering comments, but we do just want to point out, the insurance division is aware of the depth of this issue. We've brought it up with the NAIC. It's on their national agenda for meetings.

The Western Zone has also created a task force to look into this issue. We have also begun working with the child's welfare nonprofits to look at the feasibility of starting a captive to be able to pull the risk so that they can have a more affordable solution. In the interim, the division would also suggest that the Legislature look at the appropriation to DHS for these contracts so that the contract amount can reflect the higher cost of insurance. But happy to answer any questions. Thank you.

Thank you very much. Next up, we have Evan Oye for Hawaii Association of Justice in opposition. Come on up.

Hello, chairs, members of the committee. Evan Oue from the Hawaii Association for Justice. You have a written testimony. We just wanna highlight our strong opposition. Primarily, of course, we are concerned with the removal of joining several liability for the foster care agencies at this point in time.

Prime and that's, of course, because it is, you know, gonna hurt the victim the most. And, you know, we are, you know, gravely concerned that this could leave our consumers and our victims are unprotected or undercompensated for their injuries. You know? And we're also concerned that the intent of the bill it may not accomplish the intent of the bill, which is to increase availability and decrease cost of insurance at this point in time.

So, you know, as as mentioned by, I think, the the AG in previous testimony and the insurance division, you know, we would we would explore more or less harmful alternatives in terms of removing liability, which could actually bring down the cost and provide, consumers the protection. So appreciate the concern.

Very much, everyone.. Next, we have Ryan Toyomura Mihoko Ito Sanghai Government Aid Strategies in support.

Morning, Chairs. Thank you very much. Ryan Toyomura on behalf of, Parents and Children Together who, we are helping with this issue. We're in strong support of the bill. I just wanted to raise two questions that I I think would help this committee in its deliberation here.

And first question is does this bill treat child welfare welfare service providers with the same liability protections as a state? And I think the answer to that question is yes. You know, these agencies provide the the critical services that otherwise would be, required by the state to to do. And I think it's with respect to that, you know, it's fair that they receive the same liability protections.

Second, I think the a bigger question too is is does this bill prohibit a plaintiff from being made whole? That is if a child, you know, is is a victim of abuse or neglect, does it prevent that child from seeking, just justice to the the court system?

And that answer is no. There's nothing in this bill that would prevent them from being made whole. So with that, we do request an amendment here to include, the indemnification agreement, which was or indemnification language that was removed, that was previously in the bill. But and if you have any questions, I'm happy to to take that.

Thank you very much. Next, we have Allison Oeoka, Hawaii Insurance Council in support. Okay. Justin Acevedo Cross, Hawaii Community Foundation in support. Leland Brady, Aloha Independent Living Hawaii in opposition.

Lori Tachiki in support. Anybody else wishing to testify on HB 1645? Oh, come on up. Parents and children together.

Yes. Apologies. I did submit testimony and we'll make sure to get you a copy. I'm Trisha Kajimura from Parents and Children Together requesting your support on this bill. And I just wanted to give a little background on what happened.

In September 2025, our insurance re annual insurance renewal came up, and we went to the last day to find a carrier. So we were not we were almost unable to find liability insurance, and they specifically cited our child welfare services, contracts and the risk involved there. We cannot operate without liability insurance, and what happens is that we would have to, put the whole agency at risk when our child welfare services contracts are a small portion of that.

What we're asking for, as Ryan Toyomura mentioned, is that we're treated with the same protections at the as the state when it comes to liability. If we are not able to secure systemic change for this issue and we have to stop our CWS services to save the rest of the agency, we would be returning Thank you. Over 1,100 cases. Give me one second

You gotta identify yourself real fast for the record.

Trisha Kajimura, parents and children together.

Thank you.

Thank you.

Okay. Thank you. Next, anybody else wishing testify? Come on up and identify yourself, Betty.

Chairs and Vice Chair, members. I'm Betty Lou Larson with Kathy Chair Sawai We also want to respectfully ask that you, amended by reinserting the language from the HB 2. And my question is, if companies can't find or have to restrict their services, how is the state gonna take on those services? They're not fluff services.

They're critical services. And is it sustainable for the state to say, Well, we'll just have to provide the services ourselves? So that's what we're asking for a reasonable bill that would help us to be liable for the activities that we perform, but not for being an agents of the state and be responsible for other people's or other programs, activities that need liable so that still retains that ability, as someone said to sue for things that shouldn't have happened. But we feel it should be, the right person that sued. And so we ask that you, put the HB 2 language back in the bill. Thank you very much.

Okay. Anybody else wishing to testify in HB 1645? Members, any questions? I do. Insurance Commissioner, come on up. Has there been any other states who has, done this?

With regards to tort reform for the sake of child welfare service? Child welfare services. There has been a number of states that have done, tort reform, not specifically targeted at to reduce the cost of insurance. Most of them have you know, it's most mostly with regards to the liability for child welfare service providers, which is told the statute of limitations, which has led to other things. So more so on that regard, not so much what we I think are being are proposing in this bill.

Okay. So the so we don't know whether or not by passing this, we actually reduce the insurance premiums for the child welfare organization.

We cannot definitively say that that would be an outcome of this. Correct.

Okay. Thank you very much. Any other questions? Okay. Moving on.

HB 1875, relating to healthcare. First up, Hawaii State Youth Commission in support. Anybody on Zoom for Hawaii State Youth Commission?

Yes.

Okay. Please identify yourself. You have one minute.

Morning, chairs. My name is Jeremiah Jacinto, and I'm speaking on behalf of the Hawaii State Youth Commission. We stand on our written testimony, and I would like to briefly highlight a few key points. Approximately 3.6% of Hawaii's youth ages 13 to 17 identify as transgender, which is actually higher than the national average, and nearly 40% of transgender youth nationwide live in states where access to care is restricted.

Major health organizations recognize gender-affirming care as evidence-based, and research shows that it improves mental health outcomes. HB 1875 helps ensure that Hawaii remains a place where individuals can safely access medically necessary care without fear of legal consequences from other states. Protecting continuity of care is not a legal issue but a matter of health, dignity, and the survival for many young people like me. And for these reasons, we respectfully urge the committee to pass HB 1875. Thank you.

Okay. Thank you very much. Next, we have Carlotta Amerino, Office of Information Practices, providing comments. Paula Doan for Dr. Jack Lewin, SHPDA, in support. Okay. It's Terry.

Aloha. Good morning, chairs, senators. On behalf of-- my name's Terry Visperas, and on behalf of Dr. Lewin, administrator of SHPDA, we'd like to stand on our written testimony. Thank you.

Okay. Thank you very much. Okay. Next, we have Michael Golojuch Jr., Hawaii State LGBTQ Plus Commission in support. Come on up.

Good morning. Michael Golojuch Jr., he/him pronouns. I am vice chair of the Hawaii State LGBTQ Plus Commission. It is an honor and privilege to be before you today advocating for HB 1875 on behalf of the commission, a commission that you all put into place for moments like this and to fiercely advocate for bills exactly like this one. We want to thank the Youth Commission and the Commission on the Status of Women for their support.

All of us are here today because of a constant stream of attacks against our mahu transgender and gender-nonconforming ohana. It's not hyperbole to say that we are seeing daily assaults on them. These attacks started in conservative states years ago and go all the way up to the White House today. Prior to these attacks, our gender ohana-- our transgender ohana had already been facing discrimination across this nation and even the Aloha State.

Earlier this year, the Lemkin Institute has issued three different warnings about we are in the beginnings of a genocide for the transgender community. Today's bill will help stop that here in the State of Hawaii. You have read in the written testimony and you will hear today from those lived experiences. We also support the amendments from the--

Thank you very much.

--Planned Parenthood and ACOG.

Next, Hawaii Public Health Institute in support, Chris Caulfield.

Aloha, Chair, Vice Chair, and committee members. I'm Chris Caulfield from the Hawaii Public Health Institute. We're in support of this bill as numerous public health organizations have said gender-affirming care is healthcare and healthcare is a human right. This bill is about drawing that line clearly and decisively for the State of Hawaii. For those who seek it, gender-affirming healthcare is evidence-based, medically necessary, and life-saving.

The science is clear. A 2022 study from Stanford University found that transgender individuals who access gender-affirming care experience significantly better health outcomes. Every major health and medical authority agrees. The American Public Health Association and American Psychological Association both have said that access to comprehensive gender-affirming care is essential to health and well-being for the transgender community across the lifespan.

At a time when federal actions and executive orders are actively threatening access to care across the country and discriminating against the LGBT community, Hawaii has both the authority and the responsibility to act. This bill protects patients, it protects providers, and it protects the fundamental principle that healthcare decisions should be guided by medical expertise and human dignity. Thank you so much.

Thank you very much. Okay. We are going to cut off people, as you can tell, okay? And you folks know this and yelling is not going to make us vote for you any further. In fact, it will probably make it-- make us vote against you. So please follow guidelines. I know it's super emotional, but we have read your testimony. I mean, look, it's all in front of us. Despite the rain last night, we read your testimony. Okay. So if you can stand on it like Terry has done, we would love it. Okay. Next up, Abby Simmons, Stonewall Caucus of Democratic Party of Hawaii in support.

Aloha, chairs, Vice Chair, members of the committee. Abby Simmons, Stonewall Caucus, she/her pronouns. Real quick, we support HB 1875, strongly support. This bill ensures that patients, families, and medical providers who are following Hawaii law are not subject to out-of-state legal overreach, and in today's environment, that protection is not theoretical. It is urgently needed. Hawaii already faces a shortage of healthcare providers. Without clear protections, we risk losing providers or discouraging others from coming here.

This bill sends a clear and necessary message that Hawaii is a place where providers can practice medicine safely and legally. Gender-affirming care is not abstract to me. I-- personally, it is care that has supported my well-being, stability, and the ability to live authentically. I respectfully urge you to pass HB 1875. Mahalo.

Thank you very much, Abby. Okay. Next, HOKU PAC in support. HOKU PAC, are you on Zoom?

Not on Zoom, Chair.

Okay. I see Younghee Overly here for AAUW Hawaii in support. Come on up.

Good morning, chairs and Vice Chair and member of committee. Thank you for this opportunity. Younghee Overly from AAUW. In addition to the written testimony we submitted, I wanted to share with you some stories. Couple of OB/GYN friends of my son refused to go to medical school and refused to do residency in red states or purple states because they don't feel protected as medical providers.

And recently, I learned from a friend in North Carolina that her son, who was born and raised, went to medical school, and did residency in North Carolina just moved to Colorado for same reason. So you all know we already shared on the doctors and medical healthcare providers. Please share them. Thank you.

Thank you very much. Next, we have Pride at Work. Pride at Work, are you present on Zoom?

We stand in our testimony in strong support.

Thank you very much. Donavan Albano, ACLU Hawaii, in support.

Good morning. Donavan Kamakani Albano. I'm the policy fellow at ACLU of Hawaii. We stand in strong support of this measure. This bill is about guaranteeing everyone's fundamental right to bodily autonomy and privacy to accessing legal, gender-affirming, and reproductive care in Hawaii. We have seen persistent attacks from the federal government that interfere with provider-patient relationships and insurance coverage, and we believe no one should live in fear about whether they're able to make private medical decisions to accessing care that will save their lives. We strongly urge you to pass this measure. Thank you so much.

Okay. Thank you very much. Next, we have Jen Wilber, Planned Parenthood Alliance Advocates. Jen, please proceed.

I will stand in strong support and stand on our testimony too where we offered a small amendment to the bill, and thank you very much, and encourage the committee to pass it.

Okay. Thank you very much. Nahelani Parsons, Essential Access Health in support.

Mahalo. We'll stand on our testimony in support.

Okay. Thank you very much. Next, we have Camaron Miyamoto, in support. Camaron, are you present on Zoom?

Not on Zoom, Chair.

Okay. Next, we have Paige Choi, Healthcare Association of Hawaii in support, Abbra Green, Libertarian Party of Hawaii in opposition, HOPE-Hawaii Organization for Progress and Equality in support, Dr. Ignacio, Hawaii Medical Association in support, Randy Pereira, AFL-CIO Hawaii State in support, Llasmin Chaine, Hawaii State Commission on the Status of Women. Are you present, Llasmin?

Hi. Yes. Llasmin Chaine with the Commission on the Status of Women. We'll stand on our written testimony in support. Thank you for your consideration.

And I apologize for butchering your name. I should know this by now. Sorry. Michael Ching, American Academy of Pediatrics Hawaii Chapter in support. Llasmin Chaine again, Hawaii Women's Coalition in support.

Yes. The Women's Coalition will stand on its written testimony in support. Thank you.

Okay. Leeward Republican Women's Club, Mary Smart in opposition, Reni Soon, Hawaii ACOG in support. Dr. Soon, come on up.

Aloha, chairs and members of the committee. My name is Reni Soon. I'm an OB/GYN, and I'm here representing the Hawaii Section of the American College of OB/GYNs in strong support of HB 1875. We are a field where many of us are providers of gender-affirming care, and you have our written testimony. I just wanna highlight two things.

One is that HB 1875 does not change what is legal medical care here in Hawaii. It is not introducing any new practice. It's not lowering any professional standards. It is just-- it is protecting our healthcare providers and is protecting our patients from abusive overreach from other states. The second thing is we are asking for an amendment on page 7 of the bill where it's defining gender-affirming care.

We don't feel this language is adequate and so we've provided in our written testimony an amendment. We are also okay with Planned Parenthood's amendment, which is very similar to ours. Gender-affirming care is healthcare, and we respectfully ask you to pass this measure. Mahalo.

Thank you very much. Next, we have Eva Andrade, Hawaii Family Forum in opposition, Heather Lusk, Hawaii Health and Harm Reduction Center in support. Come on up, Nikos.

Aloha, Madam Chair, Vice Chair, members. Nikos Leverenz with Hawaii Health and Harm Reduction Center in strong support of this bill. We provide gender-affirming care in our Kaka'ako clinic. We also have a longstanding transgender services program, and a shout-out to my colleagues here who can speak to their lived expertise later on. But we strongly believe that this bill is necessary to protect trans folks from accessing the care that they need.

It strengthens our constitutional right to privacy against undue incursions from our federal government and attorneys general who are intent on subpoenaing and harassing, you know, our trans community and their medical providers due to their own very radical gender ideology, so we hope that they will stand down, but if they don't stand down, our trans folks need protection. Mahalo.

Thank you very much. Leelynn Brady, Aloha Independent Living Hawaii in support, Dale Vanderbrink in support, Sylvia Romm in support. Sylvia, are you present on Zoom? Please proceed.

Yes. Thank you for having me. My name is Dr. Sylvia Romm. I'm a pediatrician on Oahu, and I take care of LGBTQ youth. I strongly support HB 1875. Gender-affirming care is evidence-based, life-saving medicine, and I've seen these benefits firsthand. Providers like me need protection from retaliation simply for giving the kids the care that they need. Hawaii should stand with its providers and its LGBTQ plus families. I urge your support. Mahalo.

Okay. Thank you very much. Kim Cordery in opposition. Kim? Okay. Rick Ramirez in-- okay. Come on up, Kim. Sorry. I didn't see you.

Sorry. I just lost my-- my name is Kim Cordery. Thank you for-- I just wanted to say that I'm strongly opposed to this bill. I think there needs to be more research on this kind of care for children, and there's not enough evidence for this being-- this actually causes a risk for their health, so I'm in opposition to this bill. Thank you.

Thank you very much. HMSA, providing comments. Rick Ramirez in support. Oh, HMSA, come on up.

Morning, chairs, vice chairs, members of the committee. Moani Wright-Van Alst with HMSA. HMSA is supportive of the intent of this measure and appreciative of this committee's efforts to expand protections for reproductive health, including gender-affirming care. We will stand on our written testimony.

Okay. Thank you very much. Next, we-- Rick Ramirez in support?

Not on Zoom, Chair.

Is he on Zoom? No.

Not present, Chair.

Alissa Nelson in support. Come on up.

Aloha, chairs, vice chairs. Thank you very much for the opportunity to speak in front of you. I come with a lot of professional credentials in public health and in social work, but I'm going to leave those aside and come to you as a person and as the wife of a trans and nonbinary person. I happen to be in Senator Fukunaga's district. Thank you very much.

I'm very grateful to live there. My spouse grew up here in Hawaii. We returned here several years ago in part because this is a place where we can live openly as our fullest selves, and for them and their access to healthcare, this is essential. I've seen what it's like for a trans person to receive care that is not gender-affirming.

It causes depression, despair, hopelessness, and suicidality, and I've seen this firsthand. We know the data. We know that there's an increase in suicides across the country right now in response to these measures, and I urge you to support this bill for all of us.

Thank you very much. Next, we have Haylin Dennison in support. Haylin, are you present on Zoom?

Also not present, Chair.

D Dangaran in support. D, come on up.

Aloha, kakou. My name is D Dangaran. I'm an Assistant Professor of Law at Richardson Law School. I'm testifying as an individual, not as a UH representative. I also live in your district, Senator. So I'm supplementing my written testimony with some examples.

I teach and research constitutional law and civil rights, and I specifically focus on anti-trans legislation and anti-trans litigation. I'm in strong support of this bill because it's what protects local rule and Hawaii's state police power over-- like overreach from outside influences. So Hawaii has a right to regulate its medical providers, and it does. This bill does not change that.

It provides sound, evidence-based regulations on healthcare already. As an example, Alabama is one of the most pernicious states that actually regulates and bans with a 10-year felony anyone 19 years or under. So adults are actually subject to this ban and their providers. If they came to Hawaii for college and got this care, Hawaii would then be open to a probe or to lawsuits. So this bill should pass to protect them.

Thank you very much. Okay. Next, we have-- look, for those who have registered, we have Theresa Armbruster in opposition. Theresa? We have Margaret Mejia, Hawaii Christian Coalition in opposition. Oh. Come on up.

Aloha. My name is Margaret Menjivar. I'm from Hawaii Christian Coalition. I don't have any pronouns to quote, but I do have a scripture. God made them male and female and nothing else.

Thank you for Chair and Vice Chair and Members of the Committee. I oppose HB1875. I've been working with teenagers since 2016. Every Thursday, I teach them a class for two hours and every other Wednesday night. And I can tell you they're not ready to make this kind of decision, especially the males.

The frontal lobe in their brain is not developed until they're in their twenties. So, I'm not here to judge anyone to be violent or anything like that, but I do wanna speak on behalf of the teenagers. And, if you've heard of Chloe Cole, she's on the internet, and if you read her story, she's gone through some irreversible damage and mental issues that she experienced with transgender surgery. And this is a very serious thing. And as lawmakers, you should take it very serious.

Thank you very much. K. Next, we have for those who have registered, we have, Aloha, Chair, Mike Gwen. Mike Gwen, Aloha, Chair. Are you present on Zoom?

Not on Zoom, Chair.

K. Nicholas Leverns. Again, good policy.

Thank you very much. Renee Rave. Are you present on Zoom in support?

This morning.

Not on Zoom, Chair.

K. And we have Shailani Plasencia in support. Testimony.

Thank you for your time.

Thank you very much. Okay. We have Rainbow Family 808. Carolyn Galoyo in support. Napua Ilima in support.

Approximately 176 individuals all in support. And approximately 40 individuals all in opposition. Anybody else wishing to testify on HB1875? Okay. That person and then next to you.

Okay? Come on up.

Aloha. My name is Cheryl Toyifuku. I did submit a written testimony. I am in strong opposition of this bill 81875. You know, I do agree that the Keikis Mines, the Mopuna Mines, are not developed enough for these life changing decisions, especially when it comes to gen, gender change, according to professional reports.

And, you know, the keiki, mopuna, and the parents really need to be protected from being encouraged to have these irreversible procedures done. And, you know, they are harming children, actually, increased suicides, puberty blockers, cross sex hormones, increased mental confusion. So I strongly oppose this bill. Please protect our keiki and mopuna. Thank you very much.

Thank you very much. Okay. Next, come on up.

Aloha, Chair, Vice Chair, Members. My name is Doctor Elaine Chan. I stand here as an OBGYN who practice gender affirming care and full spectrum reproductive healthcare, and I am in strong support of HB1875. What HB1875 does is it extends existing reproductive health protections for gender affirming care.

It protects providers from abusive or retaliatory litigation, and prevents malpractice insurers and health plans from penalizing providers solely for providing already legalized care. And it strengthens patient privacy protections, and protects licensure and workforce stability. Why OBGYN supported? It ensures care is based on medical standards, not fear. It protects the patient provider relationship.

It prevents provider attrition, which is already a huge problem here, and also loss of access. It supports patients who already face barriers to care. It does not mandate care. It does not lower standards. It does not protect negligent or unlawful cases.

So I urge you to support.

Thank you very much. Anybody else wishing to testify? Come on up. And then after him, then you. Okay?

You can come up and sit in the chair right now, and you just go right after.

Okay.

Whoever's next can just come sit in the other chair.

Chair, Vice Chair, Committee, thank you for this opportunity to stand in opposition. My name is Gary Quartering. This gender affirming care this morning, much, much of the language emotionally charged, but I would like to draw to your attention or bring to your attention on 02/23/2026. The American Society of Plastic Surgeons strongly suggests that surgeons, surgery be delayed for related breast, chest, genital, and facial surgery, surgery on a patient until 19 years old.

Similarly similarly, the American Medical Association just went on record calling for the evidence on surgery for man on minors insufficient, and that it says that in the absence of clear evidence, the AMA agrees that the ASPS and surgical interventions on minors should be generally deferred until adulthood.

I think the conversation, the core conversation is the individual's rights and and a parent's rights to actually speak into these conversations about what is healthcare in this state must be accountable. And that's all we're asking for. Nobody is suggesting that the lobby amend it other than people have the opportunity to participate in the process. Thank you.

And proceed. And, why don't you come on up also and have a seat? Okay.

Aloha, Chair and Committee Members. I'm Theresa Armbruster, and I oppose HB1875 because it's protecting the wrong people. In this bill, it goes to full lengths to protect medical providers from liability and, from liability and, any kind of lawsuits, but it does not protect children. And children are vulnerable and can be easily manipulated into getting procedures that they don't understand some of the consequences until it's too late, when there's irreversible harm done to them.

And it's also possible that a person from another state could bring a minor over here and have an abortion or some kind of life changing surgery without the parents' knowledge or consent.

And the person that bring, brings the child over, they'd be protected from any kind of criminal or civil lawsuit. That is wrong. We need to protect our the most vulnerable. It seems like you're trying to protect the perpetrators and not the most vulnerable victims. So I would just ask that you really look into all areas about this and

Thank you very much.

And protect the vulnerable. Thank you.

Thank you.

Morning, Chair, Vice Chair. My name is James Wallace, and I oppose to HB1875. And let's be blunt. I'll just say it. It's mutilation.

Okay. What Google it do for a human being? Alright. What would will it make it stronger? Would they make it fast?

Would it make them faster? Smarter?

Okay.

It's a mental issue.

Oh, I'm sorry. Okay.

It's a, it's a mental health issue. Okay? Okay. That, that's all it is. So that lady even said it.

Two people already said it. It's a, the suicide rate is rocketing. Does, don't any, doesn't everyone see that? The more transgender is the more suicide rates you're gonna have. And let's end the depopulation agenda.

Last but not least, the so called health care providers. It's all about the money. We put up it in COVID. They got money out of it. They'll save lives to get money.

And Planned Parenthood, they're the number one health hormone provider in the whole United States. It's all about the money, money, money, money. It's not about health care. Thank you.

Thank you very much. Okay. Aloha.

My name is Maddalynn Sesepasara. I am in strong support of this, bills. You already have my testimony. As someone who has been doing transgender advocacy work for thirty years working with our transgender community, our community has thrived, you know, from from discrimination to housing to to now health care. I cannot believe we're talking about health care.

Everyone's health care shouldn't be on the table, but our health care is. I'm gonna let you know, they're talking about children. They're worried about children. We are too. That's why it's so important to have this them seeing these doctors, these therapists, so they can understand.

They can know that this is what they want. Because who wants anyone to go what we went through? Do, do they wanna be bullied? Do they wanna be killed? Do they wanna be discriminated?

We don't want that for children. It's hard. It's hard. So by having these providers protected, for having these patients protected, for having their parents protect, it's making sure we are making sure our babies understand what it means to be transgender and the path that we go as standing strong support.

Anybody else wishing to testify on HB1875? Members, any questions? K. Moving on. Next up, HB.

Thank you very much.

Okay. I guess the Senator Fevella.

All the way sorry. I didn't get your name.

Doctor I'm sorry. Come on up. Okay.

So I understand the I understand the health care part, but I keep hearing over and over about reproductive. What, what, what in the community of that is preventing them to getting reproductive treatment on this bill? You guys keep talking about reproductive.

I don't, I don't.

That's what you said earlier, reproductive and health care. That's what you said earlier.

It does also protect contraception care, abortion care. That's all in this, pregnancy care, miscarriage care. That is all in the spectrum of reproductive health care.

No. No.

What the, what I'm trying to

Let let's focus on this bill. I don't think this bill refers to reproductive care. It talks only about gender affirming care.

Okay. But that's what I heard she said earlier. Okay. Part of health care. Okay.

If you did, so that's the reason why I'm, I'm asking a question because we have no problem in protecting everybody's rights and what they wanna, I guess, do. So my, my issue is that I support the community. I got family members in the community. My issue is, again, having our children go into a life changing situation. I understand we have the highest suicide rates for our our mahu and our transgender community when it comes to teens.

But, again, we should be offering other things besides having the gender affirming. For me, I, I, I think if you're an adult and you wanna do these things, that, that is great. That is fine. But when we try to make decisions with the children and not with their parents or anything like that, I think that's where we, we have a hard time. So I just, I just don't understand it because I don't see why you know, and I have a, I have a good friend.

You know, she reached out to me, when, her medical didn't wanna cover, and I wrote a letter on her behalf. Because it is, she's an adult, and she wants to be a, a female. Right? She wanna be a female. And medical that she's paying for would it provide for this care and would delay her care, keep pushing them back.

I understand that part because she's an adult. She making this care. She doesn't feel good about herself. She might take her life. Understand that.

When it comes to children's agenda, agenda affirming, I have a hard time in not having more education process with the parent and the kid. When you reach one age, you can, they can do whatever they do on the 18. I just, that's the only part that I have a hard time with this bill. I, so this

I agree that this is a very important life changing decision and life saving decision. Yeah. And I agree that the our keiki can only do this with a very serious discussion with a medical provider, and this allows them to seek that care with medical providers.

Yep. So, yeah, I'm not against the.

Thank you very much.

Thank you.

Any other questions on 1875? Okay. Moving on. HB 1898 relating to health. First up, we have...

1898. Department of Health in support.

Morning, chairs, vice chairs and members of the committee. My name is Nathan Tan. I'm with the Disease Outbreak Control Division. I'm here representing the Department of Health. We stand by our written testimony in support of this measure.

We do ask if this measure passes out of committee that it be given a good date. Thank you very much.

Thank you very much. Insurance Division, DCCA, providing comments. Thank you, Paula. Dr. Lewin-Chipta in support.

Aloha. Good morning, Terry Vespares on behalf of Dr. Jack Lewin-Chipta. We'd like to stand our testimony in strong support. Thank you.

Thank you very much. Moani Wrightanoas, HMSA, providing comments.

Morning, chairs, vice chairs, members of the committee. Moani Wrightanoas with HMSA. We wanna thank the previous committee for their efforts and their amendments to put in some clarification language that if standards are different, how what the process would actually be. And so, we'll stand on our written testimony. Thank you.

Thank you very much. Paige Choi, Healthcare Association of Hawaii, in support. Elizabeth, doctor, Ignacio, Hawaii Medical Association in support. Eric Abe, Hawaii Primary Care Association, providing comments.

American Academy of Pediatrics, in support. Cheryl Toyofuku, in opposition.

Aloha. My name is Cheryl Toyofuku. I'm a mom. I'm, I'm a grandmother. I'm a retired registered nurse and a health advocate.

I transitioned to more natural, nontoxic health care over thirty years ago, and I'm in strong opposition of HB 1898. It specifically mentions I'm authorizing Department of Health to recommend standing orders for medications and vaccines. And I, over the years, I have tried to explain about the toxicity of vaccines, the ingredients, such as aborted fetal cell lines and so forth.

And so, you know, the misinformation and narrative from the American Academy of Pediatrics, who are being sued, they are in a liability for—this is for fraudulent vaccine safety claims. And also, ACIP, which is an Advisory Committee on Immunization Practices, we can just experience—we just experienced the COVID experimental mRNAs. So, this particular bill does specify vaccinations which are toxic, and I'm in strong opposition.

Thank you very much.

Our Keiki, again, need to be protected. Thank you. And our Ohana.

Thank you very much. We have Kim Cordery, in opposition.

Aloha. My name is Kim Cordery. I'm—I oppose HB 1898 as this bill gives more authority to the Department of Health with no liability. Why no liability? This is unconscionable and unconstitutional. I oppose 1898.

Thank you very much. Next, we have Teresa Armbruster in opposition.

Aloha. I'm Teresa Armbruster, and I oppose HB 1898 because it seems like the Department of Health now wants to not go beyond what the federal guidelines are for, preventive health services. They want to put their own list of recommendations and make this a statewide protocol, as opposed to following the federal guidelines.

They're saying that some vaccines now are no longer recommended, and—but the statement, the state wants to put these on the list, and they're—and trying to require all health insurers to cover whatever is on the Department of Health's list of vaccines and preventive health services, and I don't think that is right, and, also, because there is no liability.

If these are supposed to be so safe of recommendations and vaccines, why is no one—the Department of Health, doctors, pharmacists—no one's going to be held liable?

So, if there's no one held liable, then these recommendations are not reliable. And I would ask that you would just give more people health and freedom to make their choices. Thank you.

Thank you very much. Okay. We have 52 people in support, 29 people in opposition, and comments from Indivisible Hawaii Healthcare Team. Anybody else wishing to testify on HB—come on up—1898.

Aloha. My name is Margaret Menjivar from Hawaii Christian Coalition. I oppose HB 1898, and the reason we oppose it because it gives too much authority to the Department of Health. We believe that adults should make their own decisions about what goes into their bodies, and so, we oppose.

Thank you.

Thank you very much. Anybody else wishing to testify on HB 1898? Members, come on up.

If you guys like to testify, get two chairs so you guys can come up and do two chairs. I know my colleague already said that. So, get two chairs. If you guys like to testify, you guys can come up and testify. Come on up.

Mahalo. Thank you, chair, vice chair, members of the committee. I—this is Gary Quartering again, strongly opposing HB 1898. I think we've heard and continue to hear the conversation that talks about a numerous body of agencies approving and recommending these kinds of legislation and yet, excluding individual rights and liability.

If these, if these procedures and if these policies are so safe and effective, then why are we excluding liability? The people have the right to under—have the right to actually come back lawfully and challenge public policy on behalf of their health. So, this bill appears, to me, to be a, a—coinciding with the Health Care Alliance, a backdrop—a backstop against federal health care policy. I strongly oppose this. Individuals must have individual rights to bring liability lawsuits against those providers.

And in, in particular, authorizing pharmacists to administer these vaccinations, that's against the law.

Thank you very much. Mike Gwen, Aloha Care. Oh.

Sorry. I was, I was just...

No. Wait. No. Wait.

I'll wait. I'll wait.

Yeah. Okay. Mike Care—Aloha Care, in support. Mike Gwen, are you present on Zoom?

Not on Zoom, Chair.

Okay. Anybody else?

We have 33 individuals in support, two people in, three peep—two people in opposition. Anybody else wishing to testify on—excuse me. Sorry. Sorry. I was, I'm—I went too fast.

Okay. I had originally said—retract what I said. I had originally stated 52 people in support, 29 people in opposition. Anybody else wishing to testify on HB 1898? Okay.

Please proceed.

Good morning, chair, vice chair, members of committee, and I'm opposed to HB 1895 because...

1898. Sorry.

1898.

It's okay.

I already...yeah. So, come on, everybody. My body, my choice. Right?

Everybody says that. My body, my choice. Let's do it.

Did you identify yourself?

James, James Wallace. Yes. Because I mean, I know everybody agree with that. Right? My body, my choice.

Not as that's not in the agenda, but, you know, the Department of Health during the COVID and not—they're, they're fraud. You know? They, they're always pushing all these vaccines because of money. All go back to money again. Right?

They should be defunded. Let's defund Department of Health. We don't need them. So, there's another thing. We should not be force vaccinating anybody.

We shouldn't, we, it's same, same, like I said, my body, my choice. And if anybody wants to look up what it does to you, go on OpenVirus report. Go on OpenVirus report. It shows the injuries, the deaths, and, I mean, it's, it's a catastrophe, but I don't know why people are supporting this. But thank you.

Thank you very much, James. Anybody else wishing to testify on—come on up, Nikos.

I oppose it.

Very quickly. Sorry for not—I, I was instructed by our Executive Director to, to provide testimony in strong support.

Identify yourself.

My name is Nikos Leverenz with Hawaii Health and Harm Reduction Center, and we strongly support this measure. It's, it's most unfortunate that the Federal Government is turning back the clock on scientific progress. And we're very grateful that a federal judge recently invalidated the, the Department of Humans, the health secretary's very wrong headed, jettisoning of the ACIP guidelines. So, thank you for allowing me to testify.

Thank you very much. Anybody else wishing to testify on HB 1898? Come on up.

Michael Golojuch, Jr., he/him pronouns, I'm President of Pride at Work Hawaii. We stand in strong support of this measure, and we ask that the remarks from the previous testifier be entered into the record as if they were our own. Mahalo.

Thank you very much. Anybody else wishing to testify HB 1898? Members, any questions?

Yeah, Department of Health.

Department of Health. Today, we got the director.

No wonder you never answer your phone. Anyway, thank you for coming. I just wanted to ask this question. Right now, we're having any kind of outbreak, polio, or any kind of diseases that we're having now because of not having being vaccinated?

Aloha, chairs, vice chair, and committee members. I'm Kenny Fink with the Department of Health. Currently, we are seeing the wind down of a chickenpox outbreak on Kauai. We had an individual with a measles case who traveled on Hualu and Big Island. We're still in incubation period, so have not yet seen if there will be spread of that.

There was a recent wastewater detection of measles on Kauai, which would suspect—which would indicate that there may be measles circulating on Kauai that has not yet manifested itself. So, these are vaccine-preventable diseases, and we are at high risk. I do wanna be clear that this measure does not require any individual to get vaccinated. What it does is it allows access and preserves that for those who choose to receive those services.

The, the reason why I bring it up is because, you know, I mean, I'm pretty sure pretty not, not all my colleagues, but my other colleagues here, we all got vaccinated when we was young. Chickenpox, all that kinds of stuff. So, having these cases that you've been saying, I know you just said if they had the vaccination, they probably wouldn't have spread as, as bad as it was. Is, is that—is that your outlook on that?

So, vaccines reduce the risk of getting infected. Doesn't make it zero. So, the MMR, for example, is 97 percent effective, but with so much measles circulating now—right, three out of a hundred who were vaccinated may get infected with measles, but they're expected to have a case where with less severe infections, less likelihood to have those complications. Those who are not vaccinated are—so, those who are vaccinated have a three in a hundred chance of contracting measles.

Those who are unvaccinated have a ninety in a hundred chance of getting infected. So, vaccines are extremely effective at reducing the risk of spread. They not only protect individuals and their loved ones, it reduces the risk of spread throughout the community.

Thank you. Thank you, chair.

Okay. Thank you very much. Any other questions? So, I do. Insurance Commission—Insurance Commission, did they leave already?

Come on up.

Matt Tsujimura, on behalf of the Insurance Division.

Insurance Division. Well, I also had another question on the prior bill, but this one. Okay. My biggest concern in this one is what HPCA pointed out. Is it gonna screw up our Hawaii prepaid act law? Prepaid health care.

That I would have...

That was not—I did not see Attorney General's opinion on this.

Yeah. I don't—I wouldn't be able to give you a definitive answer on that, chair. I can go back to the division and have our Health Branch look at that and analyze that and get back to you.

Okay. Because the reality is we may go against federal guidelines. And if we do, even though we disagree with them, if it's gonna screw up our Hawaii Prepaid Healthcare Act, it's gonna screw the rest of us up, vaccinated or not. Right? Okay.

Thank you very much. Any other questions?

Yeah. Well, if you can just, you know, if this bill proceeds, the next committee's JDC. So.

We need an opinion.

Yeah. And then, some coordination with the Attorney General's office, which would obviously be expected to weigh in if this moves to the next committee.

Can do. Yeah. We'll coordinate with them and and proceed accordingly. Thank you.

Thank you.

Okay. Thank you very much. Okay. Okay, moving on.

HB 2121, Department of Health, relating to waste management. First up, we have Department of Health, in support.

Good morning, chairs and members of the committee. I'm Lola Irvin with the Department of Health. Thank you for hearing HB 2121, HD 2, which the Department of Health supports. It has now been moved to 328-J in the Department of Health's portion, and we did look at the definition, and it works.

And the reason is because there is so much more nicotine in these products. I found one discarded in the parking lot at Ala Moana. It has 50,000 puffs. It's mango lychee mint, and it's rechargeable. It's disposable.

And the reason for the fact that it's dischargeable is because you need to keep plugging in it, plugging it in so you can get those 50,000 puffs. It also has a screen so that you can be entertained by it. It is considered disposable. And so, in terms of the environment, then we've got nicotine in the cartridge as well as the lithium and other metals.

And so, we thank you for HB 2121, HD 2 that would protect the health of our keiki, as well as our environment.

Thank you very much. Next, we have Coalition for Tobacco-Free Hawaii Youth Council, in support. Is that you? Please identify yourself.

Aloha, chair, vice chair, and members of the committee. My name is Maya. I'm a student at Kalaheo High School, and I'm speaking on behalf of the Coalition for Tobacco-Free Hawaii Youth Council, in strong support of HB 2121. Disposable e-cigarettes are cheap, easy to use, and highly addictive, making them dangerously popular among our youth. They also harm our environment, containing plastic, toxic chemicals, and lithium-ion batteries with no proper recycling method.

In 2024, H Power reported 158 fires, many that were linked to these batteries, putting workers, facilities, and our communities at risk. We urge you to pass HB 2121. Mahalo for the opportunity to testify.

Okay. Thank you very much. Next, we have Hawaii Public Health Institute, Kevin Ramirez, in support.

Good morning, chairs, vice chair, and members of the committee. Kevin Ramirez, Program Manager for the Coalition for Equality for Hawaii with the Hawaii Public Health Institute. Thank you for hearing this measure, and I'm here to testify in strong support of this bill. Disposable e-cigarettes are harmful not only to users, but also to the environment. Each disposable e-cigarette contains no less than 10 individual components.

Those are non-biodegradable—nonbiodegradable plastic, metal. They contain hazardous chemicals and a lithium-ion battery. So, when this product enters our waste management system, they create fire risks and fire hazards. When they enter the environment, they have the potential to poison our land, waterways, wildlife, and aquatic life. So, we respectfully ask you to pass this measure, and thank you for the opportunity to testify.

Thank you very much. Next, we have Shani Kai Carvallo, in support.

Not on Zoom, chair.

Aloha Care, Mike Wen. Are you present on Zoom? In support.

Also not on Zoom.

Okay. For this one, we have Friends of Kamalani in Lydgate Park, in support, Hawaii COPD Coalition, in support, Hawaii Children Action Network Speaks, in support, American Academy of Pediatrics, Hawaii Chapter, in support, 33 other individuals in support, two in opposition, and Hawaii Smokers Alliance, in opposition. Anybody else wishing to testify on HB 2121? Members, any questions?

We, we have Attorney General. Chair?

We don't have AG here. I would have wanted to ask them questions too.

Okay. Thank you. I'll pass.

Okay. Are we ready to proceed to decision making for HHS? Okay.

So, for HHS, for HB 1573, chair's recommendation is to pass with just a single amendment. We're gonna change the effective date to 07/01/2026, making it an effective date. Any comments, questions, concerns? Seeing none, I can—excuse me. Senator Kanuha, can you...?

I will take the vote for you, madam chair.

As vice chair.

Chair votes...

Aye.

[Roll Call]

I'm sorry about that.

And for the CPN committee, because of the weather, we will not be able to make quorum on this agenda today because not enough of our members were able to get to the Capitol. So, we will defer decision making on this measure. The recommendation will be the same for the edification of everyone watching, but we will defer decision making on this measure to Tuesday, 03/24/2026, at 9:50 AM, in this room, 229.

Thank you very much. For HB 1645, HD 3, Chair does not believe that this would be—is sufficient enough to help the Child Welfare Organization. However, we are gonna keep the conversation going. We're gonna pass with amendments that be requested by parents and children together and various individuals. We're gonna add in a different effective date.

We're gonna urge the Insurance Commissioner to determine what has caused the increase in insurance premiums, whether or not it was because we passed the statute of limitations increase or any other event that has caused the increase before we try to fix it, but keeping the conversation going, pass with an amendment.

[Roll Call]

And then CPN, again, same recommendation, and we will defer decision making on this measure to Tuesday, 03/24/2026, at 9:30 AM, in Conference Room 229.

Okay. Thank you very much. For HD 1875, HD 2, chair's recommendation is to pass with amendments. We're gonna accept ACOG's and Planned Parenthood's proposed amendment, specifically Planned Parenthood's proposed amendment—technical, non-substantive amendments needed for clarity and consistency, and change the effective date of upon approval.

Any comments, questions, concerns?

Yeah. Chair, for for me, I wanna go with reservations. I want them to be protected, the community, but I just do have a little bit concern about the children. So, I'll be voting with reservations.

Thank you very much. Acting vice chair vote—chair votes aye.

[Roll Call]

And then, CPN again, same recommendation, and we will defer action on the measure to Tuesday, 03/24/2026, at 9:30 AM, in Conference Room 229.

HD 1898, HD 2. Huge concerns with it. I'd like—I note that this isn't part of the Governor's package, but we're gonna keep the conversation going and hope that the Insurance Commissioner will come up with a more definitive opinion as to whether or not our prepaid health care act is gonna be affected. Pass, we're just gonna act—pass this with a different effective date, technical, non-substantive amendments need for clarity and consistency.

So, pass with amendments, vice chair—acting vice chair. Chair votes aye.

[Roll Call]

CPN again, same recommendation, and we'll be voting on this measure on Tuesday, 03/24/2026, at 9:30 AM in Conference Room 229.

Okay. Thank you very much. So, for HB 2121, HD 2, chair notes that there is a blank appropriation. And so, we're just gonna pass this with a different effective date of 01/30/2050. Any comments, questions, concerns? Pass with amendments?

Chair votes aye.

[Roll Call]

And again, same recommendation. We'll be voting on this on Tuesday, 03/24/2026, at 9:30 AM, Conference Room 229.

And with that, the joint hearing is adjourned.