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