STAND. COM. REP. NO. 119

Honolulu, Hawaii

RE: S.B. No. 189

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. 189 entitled:

"A BILL FOR AN ACT RELATING TO BREAST CANCER SCREENING,"

begs leave to report as follows:

The purpose and intent of this measure is to expand coverage of breast cancer screening and imaging to include an annual mammogram for a woman of any age having an above-average risk for breast cancer, risk factor screening for women thirty years of age and older, and additional supplemental imaging for any woman, regardless of age, as deemed medically necessary by an applicable American College of Radiology guideline.

Your Committee received testimony in support of this measure from the Hawaii Medical Association, Hawaii Radiological Society, The Queen's Health System, and four individuals.

Your Committee received comments on this measure from the Department of Health, Department of Commerce and Consumer Affairs, and Hawaii Medical Service Association.

Your Committee finds that breast cancer that is found at an early stage is the most treatable. Your Committee further finds that financial limitations related to insurance coverage of breast cancer screening has led to critical delays and out-of-pocket costs for patients in the State. This measure reduces financial barriers to health care by expanding health insurance coverage for cancer screening for the earlier detection and diagnoses of breast cancer.

Your Committee has amended this measure by:

(1) Replacing all references to "woman" or "women" with "patient";

(2) Clarifying that insurance coverage for screening by low‑dose mammography for acute breast cancer issued on or after February 1, 1991, to include any supplemental imaging deemed medically necessary by the patient's primary care provider for a patient of any age having an above-average risk of developing breast cancer as determined by the use of a risk-factor modeling tool;

(3) Deleting language that would have required insurance coverage under policies, contracts, and agreements issued before January 1, 2026, to include formal risk‑factor screening assessments informed by available risk‑factor modeling tools for patients thirty years of age and older;

(4) Inserting language that requires insurance coverage under policies, contracts, plans, and agreements issued before January 1, 2026, to include any supplemental imaging deemed medically necessary by the patient's primary care provider for a patient of any age;

(5) Inserting an effective date of December 31, 2050, to encourage further discussion; and

(6) 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. 189, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 189, 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