A joint hearing of the Hawaii House Committees on Health and on Human Services and Homelessness advanced House Bill 553 on a voice vote after testimony from cancer patients, clinicians and advocacy groups urged the legislature to require insurer coverage for biomarker testing when ordered by a treating clinician.

Supporters said timely and comprehensive biomarker testing helps clinicians match patients to targeted therapies. Cynthia Au, government relations director for the American Cancer Society Cancer Action Network, told the committees that restrictive insurer policies across Hawaii are more stringent than national clinical guidance and risk widening disparities in precision oncology.

Patient advocates described personal bills and delays. Natalie Hyman, a Kailua resident with stage 4 metastatic breast cancer, said she received a bill for $5,800 after an insurer denied coverage for a genomic profiling test her oncologist ordered. She also said a subsequent test tied to an FDA‑approved drug remained unpaid more than 18 months after submission. Susan Hirano described a similar multi‑year appeal and a $9,600 charge incurred when an insurer refused coverage for testing her oncologist recommended.

Clinicians echoed those experiences. Shane Morita, surgical oncologist and medical officer for the American Cancer Society Hawaii chapter, described a “paradigm shift” in oncology toward precision medicine that requires testing to identify effective targeted therapies.

Representatives from insurer and provider organizations offered comments. Judith Moore Peterson, MedQUEST administrator at the Department of Human Services, said DHS appreciates the bill's intent but submitted technical comments and requested amendments. John Kirimitsu, counsel for Kaiser Permanente, and other payor representatives indicated they had submitted written testimony and were available for follow‑up.

During decision making, the committees moved HB553 forward as a house draft with technical edits and an unusual “defective” effective date (07/01/3000) to indicate further work is expected. The Committee on Health recorded unanimous aye votes from members present; the Committee on Human Services and Homelessness adopted the same recommendation.

Why it matters: Supporters said the bill would align plan coverage with clinician judgment and current evidence, increasing access to therapies that require biomarker identification. Opponents and commenters asked for clarifications about definitions, impacts on plan administration, and Medicaid implementation details.

Votes at a glance: the Health committee moved HB553 “pass with amendments” (voice roll call: Chair aye; Vice Chair aye; Members Amato, Chung, Martins, Olds, Takano Uchi, Alcos, Garcia — recorded as aye). The Human Services and Homelessness committee adopted the same recommendation.