RELATING TO MEDICAL DEBT.

Budget Healthcare

Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor: LEE, C., KEOHOKALOLE
Last action: 2026-05-08
Official status: Enrolled to Governor.
Effective date: Not listed

Plain English Breakdown

The bill does not specify exact amounts of debt forgiveness or prioritization criteria.

Medical Debt Help Program

This bill requires the Office of Wellness and Resilience to create a program that buys and forgives medical debt for certain individuals in Hawaii.

What This Bill Does

Creates a Medical Debt Acquisition and Forgiveness Program run by the Office of Wellness and Resilience.
The program will buy and forgive outstanding medical debts for individuals with household income less than or equal to four hundred percent of the federal poverty level, or those having a medical debt balance greater than or equal to five percent of their household income.
Requires the office to contract with an entity that has experience in acquiring and forgiving medical debt on behalf of state and municipal governments.
Funds the program with $500,000 from state money for fiscal year 2026-2027.
Needs a report every year about how the program is doing.

Who It Names or Affects

People in Hawaii who earn less than or equal to four hundred percent of the federal poverty level, or those with medical debt balances greater than five percent of their household income.
The Office of Wellness and Resilience, which will run the program.
Health care providers whose debts are bought by the program.

Terms To Know

Medical Debt: Money owed for medical services or treatments.
Federal Poverty Level: A measure of income used to determine eligibility for certain government programs and benefits.

Limits and Unknowns

The program only works if there is enough money available.
It does not specify how much debt will be forgiven or who gets help first.
Other states' actions related to medical debt are mentioned but not fully explained in the bill.

Amendments

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

CD1

Hawaii published version CD1

Plain English: SB3025 CD1 THE SENATE S.B.

SB3025 CD1 THE SENATE S.B.
NO.
3025 THIRTY-THIRD LEGISLATURE, 2026 S.D.
2 STATE OF HAWAII H.D.

HD1

Hawaii published version HD1

Plain English: SB3025 HD1 THE SENATE S.B.

SB3025 HD1 THE SENATE S.B.
NO.
3025 THIRTY-THIRD LEGISLATURE, 2026 S.D.
2 STATE OF HAWAII H.D.

HD2

Hawaii published version HD2

Plain English: SB3025 HD2 THE SENATE S.B.

SB3025 HD2 THE SENATE S.B.
NO.
3025 THIRTY-THIRD LEGISLATURE, 2026 S.D.
2 STATE OF HAWAII H.D.

HD3

Hawaii published version HD3

Plain English: SB3025 HD3 THE SENATE S.B.

SB3025 HD3 THE SENATE S.B.
NO.
3025 THIRTY-THIRD LEGISLATURE, 2026 S.D.
2 STATE OF HAWAII H.D.

SD1

Hawaii published version SD1

Plain English: SB3025 SD1 THE SENATE S.B.

SB3025 SD1 THE SENATE S.B.
NO.
3025 THIRTY-THIRD LEGISLATURE, 2026 S.D.
1 STATE OF HAWAII A BILL FOR AN ACT RELATING TO MEDICAL DEBT .

SD2

Hawaii published version SD2

Plain English: SB3025 SD2 THE SENATE S.B.

SB3025 SD2 THE SENATE S.B.
NO.
3025 THIRTY-THIRD LEGISLATURE, 2026 S.D.
2 STATE OF HAWAII A BILL FOR AN ACT RELATING TO MEDICAL DEBT .

Bill History

2026-05-08 S
Enrolled to Governor.
2026-05-08 S
Received notice of passage on Final Reading in House (Hse. Com. No. 888).
2026-05-06 H
Received notice of Final Reading (Sen. Com. No. 816).
2026-05-06 H
Passed Final Reading as amended in CD 1 with none voting aye with reservations; none voting no (0) and Representative(s) Alcos excused (1).
2026-05-06 S
Passed Final Reading, as amended (CD 1). Ayes, 25; Aye(s) with reservations: none . 0 No(es): none. 0 Excused: none.
2026-05-01 H
Forty-eight (48) hours notice Wednesday, 05-06-26.
2026-05-01 H
Reported from Conference Committee (Conf Com. Rep. No. 205-26) as amended in (CD 1).
2026-05-01 S
48 Hrs. Notice (as amended CD 1) 05-06-26.
2026-05-01 S
Reported from Conference Committee as amended CD 1 (Conf. Com. Rep. No. 205-26).
2026-05-01 H
The Conference Committee recommends that the measure be Passed, with Amendments. The votes were as follows: 4 Ayes: Representative(s) Marten, Keohokapu-Lee Loy, Matayoshi, Hartsfield; Ayes with reservations: none; 0 Noes: none; and 1 Excused: Representative(s) Garcia.
2026-05-01 S
The Conference committee recommends that the measure be PASSED, WITH AMENDMENTS. The votes of the Senate Conference Managers were as follows: 2 Aye(s): Senator(s) McKelvey, Lee, C.; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.
2026-04-30 H
Conference Committee Meeting will reconvene on Friday 05-01-26 2:00PM in conference room 329.
2026-04-29 H
Conference Committee Meeting will reconvene on Thursday 04-30-26 2:00PM in conference room 329.
2026-04-28 H
Conference Committee Meeting will reconvene on Wednesday 04-29-26 2:00PM in conference room 329.
2026-04-24 H
Bill scheduled for Conference Committee Meeting on Monday, 04-27-26 2:00PM in conference room 329.
2026-04-24 H
Received notice of Senate conferees (Sen. Com. No. 742).
2026-04-23 S
Senate Conferees Appointed: McKelvey Chair; Lee, C. Co-Chairs; Fevella.
2026-04-20 S
Received notice of appointment of House conferees (Hse. Com. No. 787).
2026-04-20 H
House Conferees Appointed: Marten, Keohokapu-Lee Loy, Matayoshi, Hartsfield Co-Chairs; Garcia.
2026-04-16 H
Received notice of disagreement (Sen. Com. No. 710).
2026-04-16 S
Senate disagrees with House amendments.
2026-04-16 S
Received from House (Hse. Com. No. 728).
2026-04-14 H
Passed Third Reading as amended in HD 3 with Representative(s) Shimizu voting aye with reservations; Representative(s) Pierick voting no (1) and Representative(s) Quinlan excused (1). Transmitted to Senate.
2026-04-10 H
Forty-eight (48) hours notice Tuesday, 04-14-26.
2026-04-10 H
Reported from FIN (Stand. Com. Rep. No. 2098-26) as amended in HD 3, recommending passage on Third Reading.
2026-04-07 H
The committee on FIN recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 16 Ayes: Representative(s) Todd, Takenouchi, Hartsfield, Hussey, Keohokapu-Lee Loy, Kitagawa, Kusch, Lee, M., Miyake, Morikawa, Perruso, Templo, Yamashita, Reyes Oda; Ayes with reservations: Representative(s) Alcos, Gedeon; 0 Noes: none; and 0 Excused: none.
2026-04-02 H
Bill scheduled to be heard by FIN on Tuesday, 04-07-26 2:00PM in House conference room 308 VIA VIDEOCONFERENCE.
2026-03-30 H
Report adopted; referred to the committee(s) on FIN as amended in HD 2 with Representative(s) Pierick voting aye with reservations; Representative(s) Shimizu voting no (1) and Representative(s) Cochran, Lowen, Perruso, Quinlan excused (4).
2026-03-30 H
Reported from CPC (Stand. Com. Rep. No. 1539-26) as amended in HD 2, recommending referral to FIN.
2026-03-25 H
The committee on CPC recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 11 Ayes: Representative(s) Matayoshi, Grandinetti, Chun, Ilagan, Ichiyama, Iwamoto, Kong, Lowen, Marten, Tam; Ayes with reservations: Representative(s) Pierick; Noes: none; and Excused: none.
2026-03-23 H
Bill scheduled to be heard by CPC on Wednesday, 03-25-26 2:00PM in House conference room 329 VIA VIDEOCONFERENCE.
2026-03-19 H
Passed Second Reading as amended in HD 1 and referred to the committee(s) on CPC with none voting aye with reservations; none voting no (0) and none excused (0).
2026-03-19 H
Reported from HSH/HLT (Stand. Com. Rep. No. 1244-26) as amended in HD 1, recommending passage on Second Reading and referral to CPC.
2026-03-17 H
The committee on HLT recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 8 Ayes: Representative(s) Takayama, Keohokapu-Lee Loy, Amato, Hartsfield, Marten, Olds, Takenouchi, Garcia; Ayes with reservations: none; Noes: none; and 1 Excused: Representative(s) Alcos.
2026-03-17 H
The committee on HSH recommend that the measure be PASSED, WITH AMENDMENTS. The votes were as follows: 8 Ayes: Representative(s) Marten, Olds, Amato, Hartsfield, Keohokapu-Lee Loy, Takayama, Takenouchi, Garcia; Ayes with reservations: none; Noes: none; and 1 Excused: Representative(s) Alcos.
2026-03-12 H
Bill scheduled to be heard by HSH/HLT on Tuesday, 03-17-26 10:00AM in House conference room 329 VIA VIDEOCONFERENCE.
2026-03-12 H
Referred to HSH/HLT, CPC, FIN, referral sheet 17
2026-03-12 H
Pass First Reading
2026-03-10 H
Received from Senate (Sen. Com. No. 344) in amended form (SD 2).
2026-03-10 S
Report adopted; Passed Third Reading, as amended (SD 2). Ayes, 25; Aye(s) with reservations: none . Noes, 0 (none). Excused, 0 (none). Transmitted to House.
2026-03-06 S
48 Hrs. Notice 03-10-26.
2026-03-06 S
Reported from WAM (Stand. Com. Rep. No. 2952) with recommendation of passage on Third Reading, as amended (SD 2).
2026-03-03 S
The committee(s) on WAM recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in WAM were as follows: 12 Aye(s): Senator(s) Dela Cruz, Moriwaki, DeCoite, Elefante, Hashimoto, Inouye, Kanuha, Kidani, Kim, Lee, C., Richards, Wakai; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Fevella.
2026-02-27 S
The committee(s) on WAM will hold a public decision making on 03-03-26 10:17AM; Conference Room 211 & Videoconference.
2026-02-20 S
Report adopted; Passed Second Reading, as amended (SD 1) and referred to WAM.
2026-02-20 S
Reported from HHS (Stand. Com. Rep. No. 2574) with recommendation of passage on Second Reading, as amended (SD 1) and referral to WAM.
2026-02-18 S
The committee(s) on HHS recommend(s) that the measure be PASSED, WITH AMENDMENTS. The votes in HHS were as follows: 4 Aye(s): Senator(s) San Buenaventura, McKelvey, Kanuha, Fevella; Aye(s) with reservations: none ; 0 No(es): none; and 1 Excused: Senator(s) Keohokalole.
2026-02-13 S
The committee(s) on HHS has scheduled a public hearing on 02-18-26 1:00PM; Conference Room 225 & Videoconference.
2026-01-30 S
Referred to HHS, WAM.
2026-01-26 S
Passed First Reading.
2026-01-23 S
Introduced.

Official Summary Text

RELATING TO MEDICAL DEBT.
Office of Wellness and Resilience; Medical Debt Acquisition and Forgiveness Program; Report; Appropriation ($)
Requires the Office of Wellness and Resilience to develop, implement, and administer a Medical Debt Acquisition and Forgiveness Program to acquire and forgive outstanding medical debt for residents of the State, subject to the availability of program funds. Requires a report to the Legislature. Appropriates funds. (CD1)

Current Bill Text

Read the full stored bill text

SB3025

THE SENATE

S.B. NO.

3025

THIRTY-THIRD LEGISLATURE, 2026

STATE OF HAWAII

A BILL FOR AN ACT

relating
to medical debt
.

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

����
SECTION 1.
�
The legislature finds that medical debt has
become a widespread issue in the State.
�

According to a 2022 report from the Peterson-KFF Health System Tracker, more
than one in twenty adults in the State have outstanding medical debt on their
credit report.
�
In states and cities that
have acquired and forgiven unpaid medical debt, most of the forgiven debt was
owed by those with health insurance, further suggesting that despite many
families in the State having health insurance coverage, inability to pay
medical debt is a serious problem.

����
The
legislature further finds that medical debt is a social determinant of health
as patients with burdensome medical debt often delay the care they need, may
experience issues obtaining employment and housing, have difficulty escaping
poverty, and experience increased mental stress.
�
Due to a rising cost of living and a health
care system built on a for-profit model, many families are never able to repay
medical debt.

����
The
legislature recognizes that due to the significant amount of outstanding debt
owed to hospitals and other health care providers, a secondary market has
emerged in which commercial debt buyers purchase outstanding and dormant debt
owed to health care providers and take aggressive action to collect from
families who find themselves unable to pay, further exacerbating the severity
of the medical debt crisis.

����
However,
the legislature further finds that twenty-seven states and cities in the United
States have partnered with a nonprofit organization that has successfully
purchased billions of dollars in medical debt from health care providers and
collection agencies for about 0.01 per cent of the overall cost and abolished
the respective patients' debts altogether.
�

Health care providers whose debt is sold to third parties for
abolishment can equally benefit by receiving revenue for dormant patient
accounts, while mitigating the effects of social determinants of health and
enhancing community well-being.

����
Currently,
a medical debt consolidation and cancellation non-profit organization has
already acquired the unpaid medical debt of 50,016 State residents, totaling
$91,310,664 dollars.
�
This includes
39,401 individuals on Oahu, 6,654 individuals on Hawaii Island, 3,597
individuals on Maui, Molokai, and Lanai, and 316 individuals on Kauai.

����
Accordingly,
the purpose of this Act is to require and appropriate funds for the office of
wellness and resilience to develop, implement, and administer a medical debt
acquisition and forgiveness program to acquire and forgive outstanding medical
debt for certain individuals in the State, beginning with the medical debt of the
50,016 Hawaii residents that has already been acquired by the medical debt
collection and cancellation organization.

����
SECTION
2.
�
Chapter 346, Hawaii Revised Statutes,
is amended by adding a new section to part XXI to be appropriately designated
and to read as follows:

����
"
�346-
�
Medical debt acquisition and forgiveness
program.
�
(a)
�

The office shall develop, implement, and administer a medical debt
acquisition and forgiveness program to acquire and forgive outstanding medical
debt for individuals in the State pursuant to this section.

����
(b)
�
The program shall:

����
(1)
�
Acquire and satisfy or discharge the
medical debt of individuals with a household income less than or equal to four
hundred per cent of the federal poverty level for the State, or individuals having
a medical debt balance greater than or equal to five per cent of their
household income; and

����
(2)
�
Ensure that any specific personally
identifiable information or protected health information is collected in
compliance with applicable state and federal laws and regulations, and is used only
for the purposes of acquiring and satisfying or discharging medical debt, or providing
financial education, insurance enrollment assistance, preventive measures, or
similar support services.

����
(c)
�
The office shall, without
regard to chapter 103D, or 103F, as applicable, contract with an entity
currently holding medical debt of State residents and has demonstrated
experience and success partnering with hospitals and health systems in
acquiring and
satisfying or discharging
outstanding medical debt on behalf of state and municipal governments.

����
(d)
�
The office may receive
appropriations from the legislature, private funds, or federal funds for the
purpose of acquiring and
satisfying or discharging
outstanding medical debt pursuant to this section.

����
(e)
�
The office
shall submit
a report of its findings and recommendations, including any proposed
legislation, for the medical debt acquisition and forgiveness program, to the
legislature no later than twenty days prior to the convening of each regular
session.
�
The
report shall include:

����
(1)
�
The office's progress in developing,
implementing, and administering the medical debt acquisition and forgiveness
program; and

����
(2)
�
An analysis of actions taken by
other states in the preceding year that are reasonably related to the
cancellation of medical debt, including prohibiting medical debt from appearing
on credit reports.
"

����
SECTION
3.
�
There is appropriated out of the
general revenues of the State of Hawaii the sum of $500,000 or so much thereof
as may be necessary for fiscal year 2026-2027 for the office of wellness and
resilience to develop, implement, and administer the medical debt acquisition
and forgiveness program established pursuant to section 2 of this Act to
acquire and satisfy or discharge outstanding medical debt for certain
individuals in the State, beginning with the debt that has been acquired by
medical debt collection and cancellation organizations.

����
The
sum appropriated shall be expended by the office of wellness and resilience for
the purposes of this Act.

����
SECTION
4.
�
New statutory material is
underscored.

����
SECTION
5.
�
This Act shall take effect on July 1,
2026.

INTRODUCED BY:

_____________________________

Report Title:

OWR;
Medical Debt Acquisition and Forgiveness Program; Reports; Appropriation

Description:

Requires
the Office of Wellness and Resilience to develop, implement, and administer a Medical
Debt Acquisition and Forgiveness Program to acquire and forgive outstanding
medical debt for certain individuals in the State beginning with the medical
debt of the 50,016 Hawaii residents that has already been acquired by medical
debt and consolidation organizations.
�

Requires reports to the Legislature.
�

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.