Victory in the Aloha State

After more than a decade of advocacy by Hawaiian patient and provider advocacy organizations, Hawaii Governor Josh Green signed HB 1864 into law on July 9, 2026. This legislation requires state-regulated health insurers to cover standard fertility preservation services for individuals facing iatrogenic infertility, including cancer patients. The new law will cover procedures such as sperm banking and egg and embryo freezing and go into effect for health plans issued or renewed in Hawaii after December 31, 2026.

Due to Hawaii’s Prepaid Health Care Act of 1974 (PHCA) – the nation’s only state employer health coverage mandate that predates federal ERISA law – coverage will reach a broader percentage of Hawaii’s population compared to other state fertility preservation laws. We estimate that more than 700,000 Hawaiians, approximately half of the state’s population, will now have fertility preservation coverage should they ever need it.

The Alliance for Fertility Preservation would like to thank every patient advocate and organization that has been fighting tirelessly for this coverage since the first Hawaii bill was introduced in 2012. We are especially grateful for the Hawaii Society of Clinical Oncology, ASCO, Fertility Institute of Hawaii, Breast Cancer Hawaii, ACS CAN, Blood Cancer United, Susan G. Komen and all of the patient advocates who bravely shared their stories throughout this long journey.

Fertility Preservation Toolkit

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Kyle E. Orwig, Ph.D.

Kyle E. Orwig, Ph.D.

Dr. Orwig is a Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh School of Medicine. He is also the director of the Fertility Preservation Program and the Center for Reproduction and Transplantation at Magee-Womens Hospital of UPMC. Research in the Orwig laboratory focuses on stem cells, germ lineage development, fertility and infertility. Our progress investigating reproductive function in fertile individuals provides a basis for understanding the mechanisms of infertility caused by disease, medical treatments, genetic defects or aging. Infertility impacts one in seven couples in the United States and can have a devastating impact on relationships, emotional well-being and overall health. The Orwig lab is ideally located in Magee-Womens Research Institute and Magee-Womens Hospital of the University of Pittsburgh and is committed to translating lab bench discoveries to the clinic for diagnosis, prevention and treatment of infertility.

Fertility Preservation Program in Pittsburgh http://www.fertilitypreservationpittsburgh.org
Orwig Research Group http://www.orwiglab.org