Hawaii Erased $91 Million In Medical Debt And Covered Fertility Treatments For Cancer Patients
Hawaii Governor Josh Green signed three healthcare bills into law on July 9, 2026, covering three distinct and long-standing gaps in the state's health system, each addressing a different kind of burden carried by patients across the islands. The first, Act 218, makes Hawaii the 22nd state in the country to require health insurers to cover fertility preservation services for patients undergoing medically necessary treatments that may damage their reproductive organs, including chemotherapy, radiation, and certain surgeries. For years, young Hawaiians receiving cancer diagnoses faced not only the shock of their illness but the separate and often devastating realization that their treatment could permanently end their ability to have children, with no coverage available to preserve that possibility. Act 218, which applies to policies issued or renewed after December 31, 2026, changes that. Dr. Michael Carney of the Hawaii Society for Clinical Oncologists called it a historic moment for young cancer patients who had faced the heartache of that double loss with no recourse until now.
The second measure, Act 219, expands access to colorectal cancer screenings for uninsured and underinsured residents by providing financial assistance through the Department of Human Services, and requires certain insurance plans to cover medically necessary follow-up colonoscopies after a positive screening test without any cost-sharing. Colorectal cancer is the second-leading cause of cancer-related deaths in Hawaii and kills approximately 260 residents each year, making earlier and more accessible screening a meaningful life-saving intervention. The third law, Act 220, may have the broadest immediate reach: it creates a Medical Debt Acquisition and Forgiveness Program through which the state can partner with a nonprofit organization to purchase outstanding medical debt from healthcare providers at a fraction of its face value and then cancel it entirely, requiring no action from residents. State officials estimate the program could cancel as much as $91 million in debt for up to 50,000 residents using approximately $500,000 in state funding, a return on investment that state Senator Chris Lee described as probably the best ever. Residents whose debt is purchased and cancelled will receive a notice in the mail, and roughly one in 20 Hawaii residents currently has medical debt listed on a credit report.
