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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Erica’s Story

Erica's Story - Cancer Fertility Preservation

What is your current treatment state?
Currently undergoing treatment

Did you undergo any fertility preservation treatments?
Yes, Trachelectomy

Did someone on your healthcare team speak to you about the possible effects of cancer treatments on your fertility?
Yes

Who raised the topic?
A member of my healthcare team did

Was the information you received thorough and helpful?
Yes

When were you told that your fertility might be affected by your cancer treatments?
Before I started active treatment

How did you pay for it?
It was covered by my insurance

Why did you undergo fertility preservation?
I opted to have a surgery which would preserve my fertility as my treatment option. I did so due to the fact that I was recently divorced and dating. I didn’t want any future spouse to have the option of additional children taken away.

Did you become a parent after cancer?
No

Erica’s Story

I was diagnosed with early stage cervical cancer in 2012. I underwent a trachelectomy to preserve my fertility. I waited to try to get pregnant, we were waiting until we got married. Our wedding was scheduled for June 2014, in April 2014 I was diagnosed with recurrent cervical cancer. This time we had to start aggressive treatment, they did not discuss any options for fertility at the time of my second diagnosis.

I did have a son prior to any cancer diagnosis.Read more of Erica’s story