Measures expanding healthcare access, relieving medical debt become law with governor’s signature : Big Island Now
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Hawai’i State News
Measures expanding healthcare access, relieving medical debt become law with governor’s signature
July 12, 2026, 8:00 AM HST
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Hawai‘i Gov. Josh Green recently signed three measures aimed at strengthening access to health care and alles
Access to quality health care should not depend on an individual’s ability to pay. Yet, many Hawai‘i residents are forced to choose between foregoing needed care and taking on overwhelming medical debt
These reforms — which Green signed during two separate ceremonies — help ensure people receive screenings, treatment and support they need without risking financial stability
“It is with pride that we announce these measures, which will truly transform the health and well-being of Hawaiʻi,” said Green in a state release. “Having spent years in the medical field, I have seen the gaps in the system. When our people are healthy and life-saving services are accessible and affordable, we will be a stronger and more adaptable Hawai‘i.”
Hawai‘i House of Representatives Health Committee Chairperson O‘ahu state Rep. Gregg Takayama said the measures signed help meet important healthcare needs of the community
“[House Bill] 1864 ensures that patients are not forced to choose between their immediate medical needs and their future ability to bear children,” said the legislator in the state release. “[House Bill] 1969 will save hundreds of lives by enabling early detection and treatment of colorectal cancer among uninsured residents who cannot afford this crucial procedure.”
HOUSE BILL 1864: RELATING TO INSURANCE
House Bill 1864, now Act 218, requires insurers, mutual benefit societies and health maintenance organizations to cover standard fertility preservation services for people undergoing medically necessary treatment that can cause iatrogenic infertility
This requirement applies to all policies, contracts, plans and agreements issued or renewed after Dec. 31
Because chemotherapy and radiation can damage reproductive organs and impact future fertility, many patients must grapple not only with the challenges of a serious diagnosis but with the possibility that life-saving treatment could compromise their ability to build a family
Act 218 ensures Hawai‘i residents facing this dilemma will have coverage options for preserving their fertility prior to undergoing surgery or initiation of cancer therapy
This measure makes Hawai‘i the 22nd state to make sure residents do not have to forgo the opportunity to conceive in order to receive life-saving medical treatment
“This is a historic moment for many of Hawaiʻi’s young cancer patients who, until now, not only had the heartache of receiving the devastating news of a cancer diagnosis but also had the painful realization that the treatment for their cancer would result in the permanent inability for future fertility,” said Hawaiʻi Society for Clinical Oncologists Chairperson Dr. Michael Carney in the state release. “This law — that we have worked so hard over so many years to pass — is now reality and these cancer patients can have at least a small part of their cancer journey improved. Hawaiʻi has now mandated the option of the initial protection for future fertility in these cancer survivors — hope for survival and genuine hope for a future family.”
HOUSE BILL 1969: RELATING TO COLORECTAL CANCER
Colorectal cancer is the second-leading cause of cancer-related deaths in Hawai‘i, taking the lives of roughly 260 residents each year. Many of these losses could have been prevented through timely and equitable screening
House Bill 1969, now Act 219, expands access to colorectal cancer screenings by requiring Hawaiʻi Department of Human Services to provide financial assistance to eligible residents who are uninsured, underinsured or otherwise ineligible for Medicaid
The measure also requires certain health insurance plans to cover medically necessary follow-up colonoscopies after a positive colorectal cancer screening test without deductibles, copayments, coinsurance or other cost-sharing
Surgical oncologist, American Cancer Society medical officer and American Cancer Society Cancer Action Network volunteer Dr. Shane Morita said Green’s signature to make Act 219 law makes Hawaiʻi an innovative leader for colorectal cancer screening and treatment
“Colorectal cancer is often curable when detected early, yet it remains a major cause of cancer-related death in Hawaiʻi,” said Morita in the state release. “Expanding access will reduce the burden on local families and improve survival for our patients.”
SENATE BILL 3025: RELATING TO MEDICAL DEBT
Senate Bill 3025, now Act 220, establishes a framework to relieve medical debt for as many as 50,000 Hawaiʻi residents
This enactment is years in the making — born from inventive partnerships and bold, solution‑driven work that reflects a collective dedication to progress
Act 220 requires the state Office of Wellness and Resilience to establish and administer a Medical Debt Acquisition and Forgiveness Program to purchase and eliminate outstanding medical debt for state residents, contingent on available program funds
As many as 50,000 residents could qualify, with relief totals reaching as high as $91 million
An estimated 1 in 20 Hawaiʻi residents have outstanding medical debt on their credit report. This burden delays necessary medical treatments, creates barriers to obtaining housing or employment and worsens mental distress, thus intensifying the cycle of poverty
Hawaiʻi is further disadvantaged as one of the most costly states in the nation with its for-profit healthcare system and ever-increasing living costs
Similar programs operate in 27 other cities and states throughout the nation — models for Hawaiʻi’s path
Office of Wellness and Resilience will partner with a nonprofit organization that will purchase debt from healthcare providers for a fraction of the total cost then abolish the debt altogether. This system is beneficial for all involved, as participating providers are able to receive revenue from otherwise dormant accounts
“Medical debt is one of the biggest drivers of financial ruin in Hawaiʻi,” said Hawai‘i Senate Commerce and Consumer Protection Committee Chairperson O‘ahu state Sen. Jarrett Keohokalole in the state release. Keohokalole co-introduced the bill. “[Senate Bill] 3025 ensures that thousands of families in Hawaiʻi don’t have to choose between paying rent and paying off a hospital bill.”
No one chooses medical debt — and medical emergencies can suddenly bankrupt families with even the best insurance
“This is probably the best return on investment ever — [$500,000] to cancel [$91 million] in medical debt for 50,000 local families struggling to pay their bills,” said Senate Committee on Water, Land, Culture and the Arts Chairperson O‘ahu state Sen. Chris Lee in the state release. Lee also was a co-introducer of the bill. “It will save taxpayer money by making it easier for people to see doctors again instead of ending up in the emergency room on the taxpayer dime.”
Fear of medical debt should never stand in the way of someone getting care
House Committee on Human Services and Homelessness Chairperson O‘ahu state Rep. Lisa Marten added that medical debt also should not be part of a downward financial spiral linked to bad credit or bankruptcy
“With willing partners like The Queen’s Health Systems, the state can erase medical debt and the anxiety and depression often associated with it for just pennies on the dollar,” said Marten in the state release. “People cannot actually apply for this program, rather, tens of thousands of qualified candidates will simply receive a notice with the good news that their medical debt has been erased.”
Enactment of these three measures sends a clear message: Hawai‘i is determined to build a healthcare landscape that serves people, not systems
Additional bills relating to health care signed by Green
- Senate Bill 2271 (Act 221) and Senate Bill 3132 (Act 222): Relating to hospital licensing
- House Bill 1974 (Act 223): Relating to health
- House Bill 1642 (Act 224): Relating to consumer protection
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