This amendment requires health insurance plans in Hawaii to cover fertility preservation services for patients undergoing cancer treatments that could cause infertility.
Hawaii2026Enacted
HB1864
Hawaii Law Requiring Insurance Coverage for Fertility Preservation
Last scannedAug 24, 2026, 11:30 PM
In one sentence
This law requires health insurance plans in Hawaii to cover standard fertility preservation services for people undergoing cancer treatments that may cause infertility.
What it does
- Requires insurers, mutual benefit societies, and health maintenance organizations to provide coverage for standard fertility preservation services.
- Applies the rule only to policies issued or renewed after December 31, 2026.
- Prohibits plans from denying coverage based on a person's prior diagnosis, past fertility treatments, disability status, expected length of life, degree of medical dependency, perceived quality of life, or other health conditions.
- Mandates that insurers follow the full scope of the 2018 American Society of Clinical Oncology guidelines for these services without deviation.
- Excludes experimental procedures, third-party assisted reproduction like surrogacy and donor eggs, and cryopreservation storage fees from required coverage.
Who it affects
- Health insurance companies operating in Hawaii
- Mutual benefit societies offering health plans
- Health maintenance organizations (HMOs)
- Policyholders under age twenty-six covered by these plans who face cancer treatments that may cause infertility
Limits and unknowns
- The law does not cover the cost of storing frozen eggs, sperm, or embryos (cryopreservation storage).
- Coverage is limited to procedures listed in the 2018 guidelines and excludes experimental treatments.
- The specific effective date for all policies depends on when they are issued or renewed after December 31, 2026.
Plain language
Terms to know
- Iatrogenic Infertility
- Loss of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting reproductive organs.
- Standard Fertility Preservation Services
- Procedures to save a person's ability to have children in the future as defined specifically by the 2018 American Society of Clinical Oncology guidelines.
- Medically Necessary Treatment That May Cause Iatrogenic Infertility
- Any cancer-related medical treatment with a likely side effect of infertility.
Official record
Sources
Official summary
RELATING TO INSURANCE. Insurance; Mandatory Coverage; Standard Fertility Preservation Services; Iatrogenic Infertility; Medically Necessary Treatment For policies, contracts, plans, and agreements issued or renewed after 12/31/2026, requires insurers, mutual benefit societies, and health maintenance organizations to provide coverage for standard fertility preservation services for persons undergoing medically necessary treatment that may cause iatrogenic infertility. (CD1)
Official activity
Bill history
- Act 218, on 07/09/2026 (Gov. Msg. No. 1320).H
- Act 218, 07/09/2026 (Gov. Msg. No. 1320).S
- Received notice of passage on Final Reading in House (Hse. Com. No. 888).S
- Transmitted to Governor.H
- Received notice of Final Reading (Sen. Com. No. 816).H
- Passed Final Reading as amended in CD 1 with Representative(s) Garcia voting aye with reservations; none voting no (0) and none excused (0).H
- Passed Final Reading, as amended (CD 1). Ayes, 25; Aye(s) with reservations: none . 0 No(es): none. 0 Excused: none.S
- 48 Hrs. Notice (as amended CD 1) 05-06-26S
- Reported from Conference Committee as amended CD 1 (Conf. Com. Rep. No. 79-26).S
- Forty-eight (48) hours notice Wednesday, 05-06-26.H
- Reported from Conference Committee (Conf Com. Rep. No. 79-26) as amended in (CD 1).H
- The Conference Committee recommends that the measure be Passed, with Amendments. The votes were as follows: 4 Ayes: Representative(s) Takayama, Matayoshi, Keohokapu-Lee Loy; Ayes with reservations: Representative(s) Garcia; 0 Noes: none; and 0 Excused: none.H
- The Conference committee recommends that the measure be PASSED, WITH AMENDMENTS. The votes of the Senate Conference Managers were as follows: 3 Aye(s): Senator(s) San Buenaventura, Keohokalole, McKelvey; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.S
- Conference committee meeting scheduled for 04-29-26 3:45PM; CR 329.S
- Received notice of Senate conferees (Sen. Com. No. 725).H
- Senate Conferees Appointed: San Buenaventura Chair; Keohokalole Co-Chair; McKelvey.S
- Received notice of appointment of House conferees (Hse. Com. No. 786).S
- House Conferees Appointed: Takayama, Matayoshi Co-Chairs; Keohokapu-Lee Loy, Garcia.H
- Received notice of disagreement (Hse. Com. No. 780).S
- House disagrees with Senate amendment (s).H
Changes
Amendments
5 stored
This amendment requires health insurance plans in Hawaii to cover fertility preservation services for people undergoing cancer treatments that might cause infertility.
This amendment requires health insurance plans in Hawaii to cover fertility preservation services for patients undergoing cancer treatments that might cause infertility.
This amendment requires health insurance plans in Hawaii to cover fertility preservation services for patients undergoing cancer treatments that might cause infertility.
This amendment requires health insurance plans in Hawaii to cover fertility preservation services for patients undergoing cancer treatments that might cause infertility.