HB139 • 2026

RELATING TO INSURANCE.

Healthcare

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: QUINLAN, AMATO, KAHALOA, KILA, KITAGAWA, LA CHICA, LAMOSAO, MARTEN, MATAYOSHI, PERRUSO, POEPOE, TAM
Last action: 2026-04-02
Official status: Received notice of the discharge of all House Conferees (Hse. Com. No. 457).
Effective date: Not listed

Plain English Breakdown

The effective date of December 31, 2050 is unusual and may need further clarification or verification from additional sources.

Insurance Coverage for Fertility Preservation

This bill requires insurance companies to provide coverage for fertility preservation services starting December 31, 2025.

What This Bill Does

Requires insurers, mutual benefit societies, and health maintenance organizations to cover standard fertility preservation services for individuals undergoing medically necessary treatments that may cause iatrogenic infertility after December 31, 2025.
Prohibits insurers from using prior diagnoses or fertility treatments as reasons to limit coverage for fertility preservation services.
Prevents discrimination based on life expectancy, disability, medical dependency, quality of life, or other health conditions when providing fertility preservation coverage.
Specifies that clinical guidelines must follow those set by the American Society of Clinical Oncology.

Who It Names or Affects

People who need medically necessary treatments that could cause infertility.
Insurance companies, mutual benefit societies, and health maintenance organizations in Hawaii.

Terms To Know

Iatrogenic Infertility: Infertility caused by medical treatment such as surgery, chemotherapy, or radiation.
Medically Necessary Treatment: Medical treatment that has a likely side effect of causing infertility.

Limits and Unknowns

The bill does not cover experimental procedures or third-party assisted reproduction technologies.
Effective date is set for December 31, 2050, which seems unusual and may need clarification.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

HD1

Hawaii published version HD1

Plain English: The amendment requires insurance policies and medical service plans issued or renewed after December 31, 2025, to cover standard fertility preservation services for individuals who may undergo treatments that could cause infertility.

Insurance policies must provide coverage for standard fertility preservation services if a person is going through a treatment that might lead to infertility.
The amendment ensures that insurance companies cannot use past diagnoses or previous fertility treatments as reasons to limit this new coverage.
It also states that insurers must follow guidelines set by the American Society of Clinical Oncology when deciding what services are covered.

The exact date for implementation is July 1, 3000, which seems incorrect and might need clarification or correction in the bill.
Some parts of the amendment text are incomplete or unclear, such as references to repealed sections and future dates that do not make sense.

HD2

Hawaii published version HD2

Plain English: The amendment requires health and medical service plans to cover fertility preservation services for individuals who may become infertile due to necessary medical treatments after December 31, 2025.

Health insurance policies must provide coverage for standard fertility preservation services for anyone undergoing a treatment that could cause infertility starting from January 1, 2026.
Insurance companies cannot use previous diagnoses or fertility treatments to limit this new coverage.
The definition of 'standard fertility preservation services' is based on guidelines by the American Society of Clinical Oncology and excludes experimental procedures.

The amendment text specifies an incorrect effective date (July 1, 3000) which seems to be a mistake.
Details about enforcement mechanisms or penalties for non-compliance are not provided in the given text.

SD1

Hawaii published version SD1

Plain English: This amendment adds new sections to insurance laws requiring policies and contracts issued or renewed after December 31, 2025, to cover standard fertility preservation services for individuals undergoing cancer treatments that may cause infertility.

Adds a requirement for health and accident insurance policies to provide coverage for standard fertility preservation services for insured individuals who may undergo medical treatments causing iatrogenic infertility after December 31, 2025.
Prohibits insurers from using prior diagnoses or fertility treatments as reasons to limit coverage and discriminates against those with shorter expected lifespans or disabilities.
Specifies that clinical guidelines must follow the American Society of Clinical Oncology's 2018 update and cannot exclude any services defined in these guidelines.

The amendment text is truncated, so some details about health maintenance organizations' requirements are missing.

Bill History

2026-04-02 S
Received notice of the discharge of all House Conferees (Hse. Com. No. 457).
2026-04-01 H
House Conferee(s) discharged.
2026-03-20 H
Received notice of all Senate conferees being discharged (Sen. Com. No. 409).
2026-03-20 S
Senate Conferee(s) discharged.
2025-12-08 D
Carried over to 2026 Regular Session.
2025-04-23 H
Bill scheduled for Conference Committee Meeting on Thursday, 04-24-25 3:16PM in conference room 329.
2025-04-21 S
Received notice of change in conferees (Hse. Com. No. 756).
2025-04-17 H
House Conferees Changed: Representative Matayoshi added as Co-Chair. Representative Chun discharged as Co-Chair; Added as Member.
2025-04-16 H
Received notice of Senate conferees (Sen. Com. No. 810).
2025-04-16 S
Senate Conferees Appointed: San Buenaventura Chair; Keohokalole, Moriwaki Co-Chairs; Fevella.
2025-04-15 S
Received notice of appointment of House conferees (Hse. Com. No. 732).
2025-04-14 H
House Conferees Appointed: Takayama, Chun, Keohokapu-Lee Loy Co-Chairs; Olds, Alcos.
2025-04-11 S
Received notice of disagreement (Hse. Com. No. 704).
2025-04-10 H
House disagrees with Senate amendment (s).
2025-04-08 H
Returned from Senate (Sen. Com. No. 599) in amended form (SD 1).
2025-04-08 S
Report adopted; Passed Third Reading. Ayes, 25; Aye(s) with reservations: none . Noes, 0 (none). Excused, 0 (none). Transmitted to House.
2025-04-04 S
One Day Notice 04-08-25.
2025-04-04 S
Reported from CPN/WAM (Stand. Com. Rep. No. 1821) with recommendation of passage on Third Reading.
2025-04-02 S
The committee(s) on WAM recommend(s) that the measure be PASSED, UNAMENDED. The votes in WAM were as follows: 13 Aye(s): Senator(s) Dela Cruz, Moriwaki, Aquino, DeCoite, Elefante, Hashimoto, Inouye, Kanuha, Kidani, Kim, Lee, C., Wakai, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.
2025-04-02 S
The committee(s) on CPN recommend(s) that the measure be PASSED, UNAMENDED. The votes in CPN were as follows: 5 Aye(s): Senator(s) Keohokalole, Fukunaga, McKelvey, Richards, Awa; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.
2025-03-27 S
The committee(s) on CPN/WAM will hold a public decision making on 04-02-25 10:00AM; Conference Room 211 & Videoconference.
2025-03-20 S
Report adopted; Passed Second Reading, as amended (SD 1) and referred to CPN/WAM.
2025-03-20 S
Reported from HHS (Stand. Com. Rep. No. 1197) with recommendation of passage on Second Reading, as amended (SD 1) and referral to CPN/WAM.
2025-03-17 S
The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 5 Aye(s): Senator(s) San Buenaventura, Aquino, Hashimoto, Keohokalole, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 0 Excused: none.
2025-03-11 S
The committee(s) on HHS has scheduled a public hearing on 03-17-25 1:00PM; Conference Room 225 & Videoconference.
2025-03-04 S
Referred to HHS, CPN/WAM.
2025-03-04 S
Passed First Reading.
2025-03-04 S
Received from House (Hse. Com. No. 85).
2025-02-28 H
Passed Third Reading with Representative(s) Belatti voting aye with reservations; none voting no (0) and Representative(s) Cochran, Pierick, Templo, Ward excused (4). Transmitted to Senate.
2025-02-28 H
Reported from FIN (Stand. Com. Rep. No. 901), recommending passage on Third Reading.
2025-02-21 H
The committee on FIN recommend that the measure be PASSED, UNAMENDED. The votes were as follows: 12 Ayes: Representative(s) Yamashita, Takenouchi, Grandinetti, Hussey, Keohokapu-Lee Loy, Kitagawa, Kusch, Lamosao, Miyake, Morikawa, Templo, Reyes Oda; Ayes with reservations: none; Noes: none; and 4 Excused: Representative(s) Holt, Lee, M., Alcos, Ward.
2025-02-19 H
Bill scheduled to be heard by FIN on Friday, 02-21-25 2:00PM in House conference room 308 VIA VIDEOCONFERENCE.
2025-02-12 H
Report adopted; referred to the committee(s) on FIN as amended in HD 2 with Representative(s) Belatti, Garcia voting aye with reservations; none voting no (0) and Representative(s) Cochran, Sayama, Ward excused (3).
2025-02-12 H
Reported from CPC (Stand. Com. Rep. No. 526) as amended in HD 2, recommending referral to FIN.
2025-02-06 H
The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 10 Ayes: Representative(s) Matayoshi, Chun, Ilagan, Ichiyama, Iwamoto, Kong, Lowen, Marten, Tam, Pierick; Ayes with reservations: none; Noes: none; and Excused: none.
2025-02-04 H
Bill scheduled to be heard by CPC on Thursday, 02-06-25 2:00PM in House conference room 329 VIA VIDEOCONFERENCE.
2025-02-04 H
Passed Second Reading as amended in HD 1 and referred to the committee(s) on CPC with Representative(s) Amato, Belatti voting aye with reservations; none voting no (0) and Representative(s) Cochran, Kong, Ward excused (3).
2025-02-04 H
Reported from HLT (Stand. Com. Rep. No. 65) as amended in HD 1, recommending passage on Second Reading and referral to CPC.
2025-01-31 H
The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 9 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Chun, Marten, Olds, Takenouchi, Alcos, Garcia; Ayes with reservations: none; Noes: none; and Excused: none.
2025-01-29 H
Bill scheduled to be heard by HLT on Friday, 01-31-25 9:15AM in House conference room 329 VIA VIDEOCONFERENCE.
2025-01-21 H
Referred to HLT, CPC, FIN, referral sheet 1
2025-01-16 H
Introduced and Pass First Reading.
2025-01-14 H
Prefiled.

Official Summary Text

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 12/31/2025, 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. Effective 12/31/2050. (SD1)

Current Bill Text

Read the full stored bill text

HB139

HOUSE OF REPRESENTATIVES

H.B. NO.

139

THIRTY-THIRD LEGISLATURE, 2025

STATE OF HAWAII

A BILL FOR AN ACT

relating
to insurance
.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

����
SECTION
1.
�
Chapter 431 Hawaii Revised Statutes,
is amended by adding a new section to article 10A, part I, to be appropriately
designated and to read as follows:

����
"
�431:10A-
�
Standard fertility preservation services coverage.
�
(a)
�
Each individual or group policy of accident
and health or sickness insurance issued or renewed in the State after
December 31, 2025, shall provide to the policyholder, and individuals
under twenty-six years of age covered under the policy, coverage for standard
fertility preservation services for any insured who may undergo a medically
necessary treatment that may directly or indirectly cause iatrogenic
infertility.

����
(b)
�
No policy that provides coverage for standard
fertility preservation services as required by subsection (a) shall:

����
(1)
�
Use any prior
diagnosis or prior fertility treatment as a basis for excluding, limiting, or
otherwise restricting the availability of the required coverage; or

����
(2)
�
Discriminate
based on the insured's expected length of life, present or predicted
disability, degree of medical dependency, perceived quality of life, or other
health conditions.

����
(c)
�
Any limitations imposed by a policy shall be
based on the covered individual's medical history and clinical guidelines
adopted by the insurer.
�
Any clinical
guidelines used by the insurer shall be based on the current guidelines
developed by the American Society of Clinical Oncology and shall not deviate
from the full scope of the guidelines.

����
(d)
�
As used in this section, unless the context
requires otherwise:

����
"Iatrogenic
infertility" means an impairment of fertility caused directly or
indirectly by surgery, chemotherapy, radiation, or other medical treatment
affecting the reproductive organs or processes.

����
"Medically necessary
treatment that may directly or indirectly cause iatrogenic infertility"
means medical treatment with a likely side effect of infertility as established
by the American Society of Clinical Oncology.

����
"Standard fertility
preservation services" means the procedures to preserve fertility as
outlined and established according to the professional guidelines published by
the American Society of Clinical Oncology.
�

"Standard fertility preservation services" include the full
scope of services or treatments, without any exclusions or limitations, as
defined in the most recent professional guidelines established by the American
Society of Oncology.
�
"Standard
fertility preservation services" do not include:

����
(1)
�
Any
experimental procedures or other procedures not determined to be established
medical practices by the American Society of Clinical Oncology;

����
(2)
�
Third party assisted
reproduction technology procedures, including donor egg or surrogates and
gestational carriers; and

����
(3)
�
Any services
relating to cryopreservation storage.
"

����
SECTION
2.
�
Chapter 432, Hawaii Revised Statutes,
is amended by adding a new section to article I, part VI, to be appropriately
designated and to read as follows:

����
"
�432:1-
�
Standard fertility preservation services coverage.
�
(a)
�
Each individual or group hospital or medical
service plan contract issued or renewed in this State after December 31,
2025, shall provide to the member, and individuals under twenty-six years of
age covered under the plan contract, coverage for standard fertility
preservation services for any covered person who may undergo a medically
necessary treatment that may directly or indirectly cause iatrogenic
infertility.

����
(b)
�
No
plan contract that provides coverage for standard fertility preservation
services as required by subsection (a) shall:

����
(1)
�
Use any prior
diagnosis or prior fertility treatment as a basis for excluding, limiting, or
otherwise restricting the availability of the required coverage; or

����
(2)
�
Discriminate
based on the covered person's expected length of life, present or predicted
disability, degree of medical dependency, perceived quality of life, or other
health conditions.

����
(c)
�
Any limitations imposed by a plan contract
shall be based on the covered individual's medical history and clinical
guidelines adopted by the mutual benefit society.
�
Any clinical guidelines used by the mutual
benefit society shall be based on the current guidelines developed by the
American Society of Clinical Oncology and shall not deviate from the full scope
of the guidelines.

����
(d)
�
As used in this section, unless the context
requires otherwise:

����
"Iatrogenic
infertility" means an impairment of fertility caused directly or
indirectly by surgery, chemotherapy, radiation, or other medical treatment
affecting the reproductive organs or processes.

����
"Medically necessary
treatment that may directly or indirectly cause iatrogenic infertility"
means medical treatment with a likely side effect of infertility as established
by the American Society of Clinical Oncology.

����
"Standard fertility
preservation services" means the procedures to preserve fertility as
outlined and established according to the professional guidelines published by
the American Society of Clinical Oncology.
�

"Standard fertility preservation services" include the full
scope of services or treatments, without any exclusions or limitations, as
defined in the most recent professional guidelines established by the American
Society of Oncology.
�
"Standard
fertility preservation services" do not include:

����
(1)
�
Any
experimental procedures or other procedures not determined to be established
medical practices by the American Society of Clinical Oncology;

����
(2)
�
Third party assisted
reproduction technology procedures, including donor egg or surrogates and
gestational carriers; and

����
(3)
�
Any services
relating to cryopreservation storage.
"

����
SECTION
3
.
�
Section 432D-23, Hawaii Revised Statutes, is
amended to read as follows:

����
"
�432D-23
�

Required provisions and benefits.
�
Notwithstanding any provision of law to the
contrary, each policy, contract, plan, or agreement issued in the State after
January 1, 1995, by health maintenance organizations pursuant to this chapter,
shall include benefits provided in sections 431:10-212, 431:10A-115,
431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6,
431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126,
431:10A-132, 431:10A-133,
431:10A-134,
431:10A-140, and [
431:10A-134,
]

431:10A- ,
and chapter 431M."

����
SECTION
4.
�
Statutory material to be repealed is
bracketed and stricken.
�
New statutory
material is underscored.

����
SECTION 5.
�
This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

Insurance;
Mandatory Coverage; Standard Fertility Preservation Services; Medically
Necessary Treatment

Description:

For
policies, contracts, plans, and agreements issued or renewed after 12/31/2025,
requires the 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.

The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.