REQUESTING THE AUDITOR TO ASSESS THE SOCIAL AND FINANCIAL EFFECTS OF MANDATORY HEALTH INSURANCE COVERAGE FOR PROSTHETIC DEVICES AND ORTHOTIC DEVICES.

HCR23

HOUSE OF REPRESENTATIVES

H.C.R. NO.

23

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

requesting the auditor to assess the social and financial
effects of mandatory health insurance coverage for prosthetic devices and
orthotic devices
.

����
WHEREAS,
prosthetic devices and orthotic devices play a vital role in restoring
mobility, independence, and functionality for individuals with limb loss or
limb difference or who require support for musculoskeletal impairments; and

����
WHEREAS, there
are more than 18,000 Hawaii residents living with limb loss, limb difference,
and mobility impairments who face significant barriers to participating in
physical activities and recreational opportunities and performing activities of
daily living due to outdated and discriminatory insurance coverage and policies
that routinely deny access to essential activity-specific prostheses; and

����
WHEREAS, individuals
with limb loss and limb differences in Hawaii must often rely on a single
prosthetic device, which is typically designed for limited mobility and does
not accommodate activities such as running, cycling, swimming, or bathing,
creating unnecessary risks of injury, preventable health conditions, and
diminished quality of life; and

����
WHEREAS, the
denial of coverage for activity-specific prostheses perpetuates inequities in
health, independence, and economic opportunity for individuals with
disabilities in Hawaii, forcing many to bear prohibitive out-of-pocket costs or
forgo these necessary tools entirely; and

����
WHEREAS, comprehensive
insurance coverage for prosthetic devices and orthotic devices is critical to
reducing the prevalence of preventable secondary health conditions such as
diabetes, cardiovascular disease, and obesity, which disproportionately affect
individuals with disabilities; and

����
WHEREAS,
section 23-51, Hawaii Revised Statutes, requires that "[b]efore any
legislative measure that mandates health insurance coverage for specific health
services, specific diseases, or certain providers of health care services as
part of individual or group health insurance policies, can be considered, there
shall be concurrent resolutions passed requesting the auditor to prepare and
submit to the legislature a report that assesses both the social and financial
effects of the proposed mandated coverage"; and

����
WHEREAS,
section 23-51, Hawaii Revised Statutes, further provides that "[t]he
concurrent resolutions shall designate a specific legislative bill that:

����
(1)
�
Has been introduced in the legislature; and

����
(2)
�
Includes, at a minimum, information
identifying the:

���������
(A)
�
Specific health service, disease, or provider
that would be covered;

���������
(B)
�
Extent of the coverage;

���������
(C)
�
Target groups that would be covered;

���������
(D)
�
Limitations on utilization, if any; and

���������
(E)
�
Standards of care.

For purposes of this part, mandated health insurance
coverage shall not include mandated optionals."; and

����
WHEREAS,
section 23-52, Hawaii Revised Statutes, further specifies the minimum
information required for assessing the social and financial impact of the
proposed health coverage mandate in the Auditor's report; and

����
WHEREAS,
House Bill No. 1536, introduced in the Regular Session of 2026, proposes to
expand existing health insurance mandates to provide coverage for the cost of
prosthetic devices, including activity-specific prostheses, and orthotic
devices; now, therefore,

����
BE IT
RESOLVED by the House of Representatives of the Thirty-third Legislature of the
State of Hawaii, Regular Session of 2026, the Senate concurring, that the
Auditor is requested to conduct an impact assessment report in accordance with
sections 23-51 and 23-52, Hawaii Revised Statutes, of mandating health
insurance coverage for the cost of prosthetic devices, including
activity-specific prostheses, and orthotic devices, as proposed by House Bill
No. 1536, introduced in the Regular Session of 2026; and

����
BE IT FURTHER
RESOLVED that the Auditor is further requested to include in its assessment the
impact of section 1311(d)(3) of the federal Patient Protection and Affordable
Care Act (PPACA) on House Bill No. 1536, Regular Session of 2026, that includes
but is not limited to the additional cost of any benefits beyond the essential
health benefits of Hawaii's qualified health plans under the PPACA; and

����
BE IT FURTHER
RESOLVED that the Auditor is requested to submit a report of the Auditor's
findings and recommendations, including any proposed legislation, to the
Legislature no later than twenty days prior to the convening of the Regular
Session of 2027; and

����
BE IT FURTHER
RESOLVED that certified copies of this Concurrent Resolution be transmitted to
the Auditor, Director of Commerce and Consumer Affairs, and Insurance
Commissioner.

OFFERED BY:

_____________________________

Report Title:
�

Auditor;
Impact Assessment Report; Mandatory Health Insurance Coverage; Prosthetic Devices;
Orthotic Devices