HOUSE OF REPRESENTATIVES

H.B. NO.

965

THIRTY-SECOND LEGISLATURE, 2023

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to health.

 

 

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

 


     SECTION 1.  The legislature finds that the National Institutes of Health has reported that obesity and being overweight are now the second leading cause of death nationally, with an estimated three hundred thousand deaths a year attributed to the epidemic.  Obesity increases the risk for chronic diseases and conditions, including high blood pressure, heart disease, certain cancers, arthritis, mental illness, lipid disorders, sleep apnea, and type 2 diabetes.  The legislature finds that clinicians increasingly recognize that obesity is closely linked to genetics and environmental factors.

     The legislature further finds that more than half of medicare beneficiaries are treated for five or more chronic conditions per year.  The rate of obesity among medicare beneficiaries doubled from 1987 to 2002 and nearly doubled again by 2016, with medicare spending on individuals with obesity during that time rising proportionately to reach $50 billion in 2014.  On average, a medicare beneficiary with obesity costs $2,018 more than a healthy-weight beneficiary.

     Accordingly, the purpose of this Act is to require health insurance providers to include in their policies coverage for weight management medication for individuals covered under the policy.

     SECTION 2.  Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

     "§431:10A-    Coverage for weight management medication.  (a)  Each individual or group policy of accident and health or sickness insurance delivered or issued for delivery in this State after December 31, 2023, shall provide coverage for medication used for:

     (1)  The treatment of obesity; or

     (2)  Weight loss management for an insured who is overweight and has one or more related comorbidities.

     (b)  For the purposes of this section:

     "Obesity" means a body mass index greater than or equal to thirty kilograms per square meter.

     "Overweight" means a body mass index greater than twenty-five, but less than thirty, kilograms per square meter."

     SECTION 3.  Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article 1 to be appropriately designated and to read as follows:

     §432:1-    Coverage for weight management medication.  (a)  Each individual and group hospital or medical service plan contract delivered or issued for delivery in this State after December 31, 2023, by a mutual benefit society shall provide coverage for medication used for:

     (1)  The treatment of obesity; or

     (2)  Weight loss management for a member who is overweight and has one or more related comorbidities.

     (b)  For the purposes of this section:

     "Obesity" means a body mass index greater than or equal to thirty kilograms per square meter.

     "Overweight" means a body mass index greater than twenty-five, but less than thirty, kilograms per square meter."

     SECTION 4.  Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

     "§432D-23  Required provisions and benefits.  Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, and [431:10A-134,] 431:10A-  , and chapter 431M."

     SECTION 5.  This Act does not affect rights and duties that matured, penalties that were incurred, and proceedings that were begun before its effective date.

     SECTION 6.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 7.  This Act shall take effect upon its approval.

 

INTRODUCED BY:

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Report Title:

Health Insurance; Mandatory Health Coverage Weight Management Medication; Obesity; Overweight; Comorbidities

 

Description:

Requires health insurers, mutual benefit societies, and health maintenance organizations to provide coverage for medication used for the treatment of obesity or weight loss management for a covered individual who is overweight and has one or more related comorbidities.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.