Honolulu, Hawaii


RE: S.B. No. 827

S.D. 1




Honorable Ronald D. Kouchi

President of the Senate

Thirty-First State Legislature

Regular Session of 2021

State of Hawaii




Your Committee on Health, to which was referred S.B. No. 827 entitled:




begs leave to report as follows:


The purpose and intent of this measure is to:


(1) Increase the categories of women required to be covered for mammogram screenings;


(2) Require the existing health insurance mandate for coverage of low-dose mammography to include digital mammography and breast tomosynthesis;


(3) Define "digital breast tomosynthesis"; and


(4) Require healthcare providers to be reimbursed at rates accurately reflecting the resource costs specific to each service, including any increased resource cost after January 1, 2021.


Your Committee received testimony in support of this measure from Hawaii Medical Association, Hawaii Radiological Society, Hawaii Society of Clinical Oncology, Hawaii Primary Care Association, Planned Parenthood Votes Northwest and Hawaii, Hawaii Women Lawyers, Hawaii Pacific Health, Pacific Radiology Group, and eight 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 Health, Department of Commerce and Consumer Affairs, and Kaiser Permanente Hawaii.


Your Committee finds that the data is clear: annual mammographic screenings significantly reduce breast cancer deaths and morbidity and that effective screening programs are in the best interest of Hawaii's people. Moreover, your Committee finds that increasing mammographic screenings would be particularly beneficial in Hawaii because research shows that women of Asian ancestry in Hawaii are the ethnic group most likely to develop breast cancer before age fifty. Women in Hawaii between the ages of forty and forty-nine have a higher incidence of breast cancer compared to the U.S. national average. Additionally, native Hawaiian women have the greatest breast cancer incidence and mortality in Hawaii. Nationally, half of all fatal cancers are diagnosed in women before age fifty in the general population. This measure would improve the health and wellness of women in the State by increasing the categories of women required to be covered for mammogram screenings.


Your Committee recognizes the testimony of Kaiser Permanente Hawaii, which offered an amendment to clarify the measure. Your Committee heard the testimony of the Insurance Commissioner of the Department of Commerce and Consumer Affairs, who testified that because the measure does not include chapter 432D, Hawaii Revised Statutes, entities, i.e., health maintenance organizations, it will not apply to the Kaiser Foundation Health Plan. Your Committee finds, however, that the measure amends section 431:10A‑116, Hawaii Revised Statutes. This section is included among those sections listed in section 432D-23, Hawaii Revised Statutes, which are benefits that must be included in each policy, contract, plan, or agreement issued in the State by health maintenance organizations. As such, through the amendments made to section 431:10A-116, this measure would apply to the Kaiser Foundation Health Plan.


Your Committee has amended this measure by:


(1) Replacing the phrase "annual baseline mammogram" with "baseline mammogram";


(2) Inserting an effective date of July 1, 2050, to encourage further discussion; and


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


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 S.B. No. 827, as amended herein, and recommends that it pass Second Reading in the form attached hereto as S.B. No. 827, S.D. 1, and be referred to your Committee on Commerce and Consumer Protection.


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