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HB2456
HOUSE OF REPRESENTATIVES
H.B. NO.
2456
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII
A BILL FOR AN ACT
relating
to drugs for weight loss
.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
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SECTION 1.
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The
legislature finds that glucagon-like peptide‑1 drugs, commonly known as GLP‑1
drugs, have been used for decades as an effective treatment for type 2 diabetes
mellitus, and drug insurance policies generally provide coverage for these
medications when prescribed for that purpose.
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In recent years, GLP‑1 drugs have also gained significant
attention for their effectiveness in treating obesity.
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However, due to their high cost, insurance
coverage for GLP‑1 drugs prescribed for obesity remains relatively limited
in Hawaii.
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In addition, while state medicaid
programs must cover nearly all drugs approved by the United States Food and
Drug Administration for medically accepted indications, a long‑standing
statutory exception under 42 United States Code section 1396r‑8(d)(2)(A)
allows states to choose whether to provide medicaid coverage for weight‑loss
drugs for adults.
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As a result, although
the United States Food and Drug Administration has approved the GLP‑1
drugs Saxenda (liraglutide), Wegovy (semaglutide), and Zepbound (tirzepatide)
for purposes of weight loss, the State of Hawaii department of human services
has opted to exclude these medications from coverage under medicaid and medicare
part D in most situations.
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The legislature believes that GLP-1 drugs
should be covered for weight loss purposes, because GLP-1 drugs are effective for
addressing obesity, a major health issue linked to diabetes, heart disease, and
other conditions.
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Addressing one of the
major contributors to disease will help lower overall healthcare costs for
everyone.
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Accordingly, the purpose of this Act is to
require the department of human services to remove the coverage exclusion for glucagon-like
peptide‑1 drugs that have been approved by the United States Food and
Drug Administration for weight loss purposes, thereby allowing medicaid and
medicare part D coverage for certain glucagon-like peptide‑1 drugs to
treat obesity.
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SECTION 2.
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(a)
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No later than August 1, 2026,
the department of human services shall issue temporary rules without regard to
chapter 91, Hawaii Revised Statutes, to effectuate subsection (c).
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The temporary rules shall be effective until
amended or superseded by the rules adopted under subsection (b).
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(b)
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No later than January 1, 2028, the department of human services shall adopt
rules under chapter 91, Hawaii Revised Statutes, to effectuate subsection (c).
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(c)
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Any
patient who is a medicaid or medicare part D prescription drug program
recipient shall be eligible for coverage of glucagon-like peptide‑1 drugs
as agents when used for weight loss; provided that:
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(1)
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The
glucagon-like peptide‑1 drug is approved by the United States Food and
Drug Administration for purposes of weight loss;
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(2)
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The
glucagon-like peptide‑1 drug is prescribed by a practitioner; and
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(3)
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Prior
authorization shall not be required.
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For purposes of this Act,
"practitioner" shall have the same meaning as in section 461-1,
Hawaii Revised Statutes.
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SECTION 3.
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There is appropriated out of the general revenues of the State of Hawaii
the sum of $
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or
so much thereof as may be necessary for fiscal year 2026-2027 for medicaid and
medicare coverage of glucagon-like peptide‑1 drugs as agents for weight
loss.
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The sum appropriated shall be expended by
the department of human services for the purposes of this Act.
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SECTION 4.
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This Act shall take effect on July 1, 2026.
INTRODUCED BY:
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Report Title:
DHS; Weight
Loss; Obesity; Medicare; Medicaid; GLP-1; Appropriation
Description:
Requires
the Department of Human Services to provide Medicaid and Medicare part D
prescription drug program recipients with coverage of glucagon-like peptide-1 (GLP-1)
drugs for weight loss.
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Appropriates
funds.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.