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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Rosanna’s Story

Rosanna - Cancer Fertility Preservation

What is your current treatment state?
Recently diagnosed

Did you undergo any fertility preservation treatments?
Yes, Embryo Freezing

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?
I used a financial assistance program,I paid for it out of pocket

Did you become a parent after cancer?
Not yet but I would like to

Rosanna’s Story

I was diagnosed at a young age when I was engaged. While we had talked about having kids at some point, we were forced to make some huge decisions much sooner than we had planned because of my diagnosis. We froze both eggs and embryos, but are hopeful to be able to have kids naturally. Having this as a backup provides a sense of relief knowing we have a backup plan. We can’t try for another 3 years so until then, we’re starting the adoption process!