HOUSE OF REPRESENTATIVES	H.C.R. NO.	134
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

requesting the auditor to conduct an impact assessment of eliminating cost-sharing for certain diagnostic and supplemental breast examinations.

WHEREAS, Hawaii ranks the fourth highest for breast cancer incidence in the country, and incident rates continue to increase; and

WHEREAS, the American Cancer Society recommends that high risk-patients or women with dense breast tissue category 3 should receive a mammogram and a breast MRI every year starting at the age of thirty; and

WHEREAS, diagnostic imaging is conducted on patients who do exhibit symptoms of breast cancer, or who have had an abnormal mammography result; and

WHEREAS, supplemental imaging is conducted on patients who have already been diagnosed with breast cancer, or who have been deemed to be at a high risk for breast cancer due to a family history of the disease; and

WHEREAS, breast cancer screening and follow-up imaging have significantly increased the early detection of breast cancer in the past twenty-five years; and

WHEREAS, it is not required for insurers to cover supplemental examinations or follow-up diagnostic screenings, which could result in costs ranging from hundreds to thousands of dollars; and

WHEREAS, a 2019 study by the Susan G. Komen Breast Cancer Foundation found cost as the primary reason women avoid follow-up diagnostic imaging recommended by their healthcare provider; and

WHEREAS, removing financial barriers to follow-up diagnostic and supplemental breast examinations is critical for the health and economic security of women in Hawaii and will help avoid more costly treatments in the future; and

WHEREAS, numerous states have enacted legislation that eliminates patient cost-sharing for diagnostic and supplemental breast imaging; and

WHEREAS, section 23-51, Hawaii Revised Statutes, requires that, before considering 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, the Legislature shall adopt a concurrent resolution asking the Auditor to prepare and submit to the Legislature a report that assesses the social and financial effects of the proposed mandatory coverage; 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; now, therefore,

WHEREAS, House Bill No. 598, introduced during the Regular Session of 2025, proposes to prohibit the imposition of cost-sharing requirements for certain diagnostic and supplemental breast examinations; and

BE IT RESOLVED by the House of Representatives of the Thirty-third Legislature of the State of Hawaii, Regular Session of 2025, the Senate concurring, that the Auditor is requested to conduct an impact assessment in accordance with sections 23-51 and 23-52, Hawaii Revised Statutes, of eliminating cost-sharing for certain diagnostic and supplemental breast examinations as proposed by House Bill No. 598, Regular Session of 2025; and

BE IT FURTHER RESOLVED the Auditor is requested to include in its assessment the impact of the Affordable Care Act, Employee Retirement Income Security Act, and Prepaid Health Care Act on House Bill No. 598, or similar legislation, 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 Affordable Care Act; and

BE IT FURTHER RESOLVED 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 2026; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to 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; Cost-Sharing Prohibition; Diagnostic and Supplemental Breast Examinations.