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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Joanna Rudnick

Joanna Rudnick

Joanna Rudnick is an Emmy-nominated documentary director and producer. In her directorial debut In The Family (POV|PBS), she told her personal story about coming to terms with learning that she had a BRCA1 mutation, dramatically increasing her risk for breast and ovarian cancer. The film was the first to cover the world of predictive genetic testing via a verité treatment and was screened as part of the successful effort to pass the Genetic Information Non-Discrimination Act (GINA) as well as challenge gene patenting, a case that went to the Supreme Court. Ms. Rudnick’s directing credits include the feature documentary Story & Pictures By (currently on the festival circuit), Brother (Independent Lens|PBS), the duPont Award winning Hard Earned (Al Jazeera America) and On Beauty (Audience Award Best Short, Chicago Film Festival). Her producing credits include Bill T. Jones: A Good Man (American Masters|PBS); Crossfire Hurricane, a documentary about the 50th anniversary of the Rolling Stones (HBO); and Robert Capa In Love and War (PBS|BBC), among others.