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State Laws

Hawaii


Political Information

Executive (Governor)

Pro-choice

Senate

Pro-choice

House

Pro-choice

Abortion-Care Policies

Abortion Providers

Abortion Providers: Restrictions

Restrictions on Who May Provide Abortion Services

Hawaii prohibits certain qualified health-care professionals from providing abortion services.

Only a licensed physician or surgeon or a licensed osteopathic physician and surgeon may provide abortion care.  Haw. Rev. Stat. Ann. § 453-16(a)(1) (Enacted 1970; Last Amended 2006).


Abortion Rights

Protections: Freedom of Choice Act (FOCA)

Hawaii has created additional protections for reproductive rights by adding an affirmative right to choose into its state law.  This law ensures women’s access to previability abortion services and would remain in effect even if Roe v. Wade were overturned.

"The State shall not deny or interfere with a female’s right to choose or obtain an abortion of a nonviable fetus or an abortion that is necessary to protect the life or health of the female."  Haw. Rev. Stat. § 453-16 (Enacted 2006).


Biased Counseling

No state measure.

Mandatory Delays

No state measure.

Insurance Coverage & Abortion

Supports Insurance Coverage of Contraception

Hawaii law requires health-insurance plans to provide coverage for prescription contraception.

What is required?  Health-insurance plans must provide coverage for contraception, defined as all Food and Drug Administration-approved prescription contraceptive drugs or devices used to prevent pregnancy.  Insurers are required to provide coverage for at least one brand of oral contraceptive from the monophasic, multiphasic, and the progestin-only categories.  Additional types of oral contraceptives must be covered only if the use of covered brands has resulted, or could result, in an adverse drug reaction.

To which insurance plans does the law apply?  Employer group health insurance plans issued or renewed on or after January 1, 2000.

Does the law provide additional protections for women?  Yes.  Insurers may not impose unusual copayments, charges, or waiting periods for contraception.

Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage?  Yes.

To whom does the refusal clause apply?  Religious employers, or any educational, health-care, or other nonprofit institution or organization owned or controlled by a religious employer, for whom contraception is contrary to their religious tenets.

What does the refusal clause allow?  A religious employer, or any educational, health-care, or other nonprofit institution or organization owned or controlled by a religious employer, may require issuers of its health-insurance plans to exclude coverage of contraceptive services and supplies.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?  Yes.  The law exempts a "religious employer" defined as a nonprofit organization that has the purpose of inculcation of religious values, primarily employs persons who share the religious tenets of the entity, and is not staffed by public employees, as well as any educational, health-care, or other nonprrofit institution or organization owned or controlled by a religious employer.  This broad refusal clause inappropriately includes entities that operate in the public sphere.

Does the law require the refusing entity to notify the persons affected?  Yes.  An employer exercising a refusal clause must:  (1) provide written notice to enrollees upon enrollment in the health plan, listing the contraceptive health-care services the employer refuses to cover for religious reasons; and (2) provide prompt written information describing how to access contraception.

Are there circumstances under which a refusal clause may not be exercised?  Yes.  A refusal clause may not be used to exclude coverage for prescription contraception ordered for reasons other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating the symptoms of menopause, or for prescription contraception necessary to preserve the life or health of an enrollee.

Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?  Yes.  Enrollees in an exempted health plan may purchase contraceptive coverage directly from the insurer, and the cost shall not exceed the enrollee’s pro-rata share of the price the group purchaser would have paid had the employer not invoked the religious exemption.

Haw. Rev. Stat. Ann. §§ 431:10A-116.6 (Enacted 1993; Last Amended 2003), -116.7 (Enacted 1999, Last Amended 2003); 432:1-604.5 (Enacted 1999).


Improves Insurance Coverage of Contraception

Hawaii law requires health-insurance plans cover dispensing of a 12-month supply of prescription contraceptives.

What is required?  Health-insurance plans must reimburse providers and pharmacies for dispensing up to a 12-month supply of contraceptives.

Haw. Rev. Stat. § 431:10A-116.6 (2016); Haw. Rev. Stat. § 432:1-604.5 (2016).


Low-Income Women & Abortion

Supports Low-Income Women’s Access to Abortion

Hawaii allows women eligible for medical assistance for general health care to obtain state funds for abortion.  No prior authorization is required.  Haw. Admin. Rules § 17-1727-49(c)(7); Med-Quest Div., Hawaii Dept. of Human Servs., Medicaid Provider Manual, ch. 6, § 6.1 (Rev. Jan. 2011), at http://www.med-quest.us/PDFs/Provider%20Manual/PMChp0611.pdf.


Young Women & Abortion

No state measure.

Family-Planning Policies

Insurance Coverage & Contraception

No state measure.

Low-Income Women & Contraception

No state measure.

Emergency Contraception

EC in the ER

Hawaii law ensures that sexual-assault survivors receive access to emergency contraception (EC) in hospital emergency rooms.  As part of the minimum standards for the examination and treatment of a sexual-assault survivor, a physician or other health-care provider must offer a sexual-assault survivor EC and provide EC to her upon request. Haw. Rev. Stat. Ann. § 321-512 (Enacted 2013).


Other Important Issues

Clinic Protections

No state measure.

Fake Health Centers

State Regulates Crisis Pregnancy Centers

Hawaii law protects women against CPCs’ worst practices. The law requires  limited service pregnancy centers to inform women about the state programs available for affordable comprehensive family planning.  S.B.501, 29th Leg. Reg. Sess. (HI 2017) (to be codified at Haw. Rev. Stat. § 321A, 321B.


Refusals & Guarantees

Refusals of Medical Care

ABORTION REFUSAL CLAUSE

Hawaii allows certain individuals or entities to refuse to provide abortion services.

To whom does the refusal clause apply?  Individuals and hospitals.

What does the refusal clause allow?  Allows individuals and hospitals to refuse to participate in abortion services.  No individual or hospital may be liable for refusing to participate.

Does the law require the refusing individual or entity to notify the persons affected?  No.

Are there circumstances under which a refusal clause may not be exercised?  No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services?  No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause?  No.

Haw. Rev. Stat. Ann. § 453-16 (Enacted 1970; Last Amended 2008).

HEALTH-CARE PROVIDER AND HEALTH-CARE INSTITUTIONS REFUSAL CLAUSE

Hawaii allows certain individuals or entities to refuse to comply with an individual health-care instruction or decision based on conscience.

To whom does the refusal clause apply?  Health-care providers and health-care institutions.

What does the refusal clause allow?  Health-care providers may decline to comply with an individual instruction or health-care decision based on conscience.  A health-care institution may decline to comply with an individual instruction or health-care decision if contrary to a policy of the institution which is expressly based on conscience.

Does the law require the refusing individual or entity to notify the persons affected?  Yes.  A health-care provider or health-care institution that refuses to comply with an individual health-care instruction or health-care decision must promptly inform the patient.

Are there circumstances under which a refusal clause may not be exercised?  No.

Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for the requested health services?  No.

Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause?  Yes.  A health-care provider or health-care institution that refuses to comply with an individual health-care instruction or health-care decision must (1) inform the patient promptly; (2) make all reasonable efforts to assist in the transfer of the patient to another health-care provider or institution that is willing to comply with the instruction or decision; and (3) provide continuing care to the patient until the transfer is accomplished or until it appears that a transfer cannot be accomplished.

Haw. Rev. Stat. Ann. § 327E-7 (Enacted 1999).

INSURANCE COVERAGE FOR CONTRACEPTION REFUSAL CLAUSE

Although Hawaii law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception, certain employers and/or insurers may require that their plans exclude coverage for contraception.

To whom does the refusal clause apply?  Religious employers for whom contraceptive services and supplies are contrary to their religious tenets.

What does the refusal clause allow?  A religious employer may require issuers of its health-insurance plans to exclude coverage of contraceptive services and supplies.

Does the law require the refusing entity to notify the persons affected?  Yes.  An employer exercising a refusal clause must: (1) provide written notice to enrollees upon enrollment in the health plan, listing the contraceptive services the employer refuses to cover for religious reasons; and (2) provide prompt written information describing how to access contraception.

Are there circumstances under which a refusal clause may not be exercised?  Yes.  A refusal clause may not be used to exclude coverage for prescription contraception ordered for reasons other than contraceptive purposes, such as decreasing the risk of ovarian cancer or eliminating the symptoms of menopause, or for prescription contraception necessary to preserve the life or health of an enrollee.

Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?  Yes.  Enrollees in an exempted health plan may purchase contraceptive coverage directly from the insurer, and the cost of purchasing such coverage shall not exceed the enrollee’s pro-rata share of the price the group purchaser would have paid had the employer not invoked the religious exemption.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?   Yes.  The law exempts a "religious employer" defined as a non-profit organization that has the purpose of inculcation of religious values, primarily employs persons who share the religious tenets of the entity, and is not staffed by public employees, as well as any educational, health-care, or other non-profit institution or organization owned or controlled by a religious employer.  This broad refusal clause inappropriately includes entities that operate in the public sphere.

Haw. Rev. Stat. Ann. §§ 431:10A-116.6 (Enacted 1993; Last Amended 2003), -116.7 (Enacted 1999; Last Amended 2003), 432:1-604.5 (Enacted 1993; Last Amended 1999).


Counseling & Referral Bans

No state measure.

Everyone should be able to decide if, when, how, and with whom they start or grow a family.

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