STAND. COM. REP. NO.  196-20


Honolulu, Hawaii

                , 2020


RE:   H.B. No. 2105

      H.D. 1





Honorable Scott K. Saiki

Speaker, House of Representatives

Thirtieth State Legislature

Regular Session of 2020

State of Hawaii




     Your Committee on Health, to which was referred H.B. No. 2105 entitled:




begs leave to report as follows:


     The purpose of this measure is to authorize physicians to engage in collective mediation with health benefit plans.


     Your Committee received testimony in support of this measure from the Office of the Mayor of the County of Hawaii, Hawaii Medical Association, Hawaii College of Emergency Physicians, Hawaii Physician Shortage Crisis Task Force, and twelve individuals.  Your Committee received testimony in opposition to this measure from the Hawaii Medical Service Association and Hawaii Association of Health Plans.  Your Committee received comments on this measure from the Department of the Attorney General, Hawaii Medical Board, Civil Beat Law Center for the Public Interest, and Kaiser Permanente Hawaii.


     Your Committee finds that this measure is modeled after an Alaska law enacted in 2002, which allows physicians and insurers to collectively convene for discussion, with the goal of improving contractual relations and improving access to care.  However, your Committee notes the concerns raised by the Department of the Attorney General in testimony that this measure may be subject to federal preemption by the federal Employee Retirement Income Security Act, since it exempts self-insured health benefit plans.  Concerns were also raised that this measure may conflict with federal antitrust laws.  In light of these concerns, your committee believes that a study on this issue is prudent. 


     Accordingly, your Committee has amended this measure by:


     (1)  Deleting language authorizing physicians to engage in collective mediation with health benefit plans;


     (2)  Requiring the Department of the Attorney General to conduct a feasibility study on whether the Legislature may authorize competing physicians to engage in collective mediation with health benefit plans, including federal preemption and other legal concerns associated with this type of collective action;


     (3)  Changing the effective date to July 1, 2050, to encourage further discussion; and


     (4)  Making technical, nonsubstantive amendments for the purposes of clarity, consistency, and style.


     As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 2105, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 2105, H.D. 1, and be referred to your Committee on Consumer Protection & Commerce.



Respectfully submitted on behalf of the members of the Committee on Health,