Hawaii House Bill HB221

Hawaii 2025 Regular Session

• Introduced: 1/17/25
• Refer: 1/21/25

Caption

Relating To Medical School Tuition.

Summary

HB221 would create a new statutory requirement tied to resident tuition at the University of Hawaii John A. Burns School of Medicine (JABSOM). The bill applies to students who paid Hawaii resident tuition while enrolled in the MD program and who are awarded a medical degree after January 1, 2029. Those graduates would be required to begin serving as a physician in Hawaii within five years after completing residency or fellowship, and then remain in the state for at least two consecutive years. If a covered graduate does not meet the service requirement, the bill requires reimbursement to the State for the difference between resident and nonresident tuition for each year the student paid the lower resident rate. The bill also authorizes the JABSOM dean to grant exemptions or extend the service-start deadline for extenuating circumstances, requires the University of Hawaii to monitor compliance and collect amounts owed, and directs annual reporting to the Legislature beginning in 2036.

Impact

The bill would add a new subpart to Chapter 304A, Hawaii Revised Statutes, creating a tuition-linked service obligation for certain JABSOM graduates. It would affect medical students who benefit from resident tuition, the University of Hawaii’s administration and enforcement responsibilities, and the State’s ability to recover the tuition subsidy if graduates do not practice in Hawaii as required. It also establishes a reporting framework and collection authority, including use of private collection agencies.

Sentiment

The bill’s stated purpose and framing are strongly supportive of increasing Hawaii’s physician workforce and retaining more JABSOM graduates in-state. The findings emphasize a significant physician shortage, the public subsidy behind resident tuition, and the higher retention rate among graduates who complete residency in Hawaii. No committee testimony, votes, or recorded opposition were provided, so the available record reflects a policy rationale that is generally favorable to the bill rather than a documented debate.

Contention

The main potential point of contention is the bill’s mandatory service commitment and financial penalty for noncompliance, which could be viewed as a condition on the benefit of resident tuition. Another likely issue is administrative discretion: the dean may exempt individuals or extend deadlines for extenuating circumstances, which could raise questions about fairness, consistency, and rulemaking. The bill also shifts enforcement burdens to the university and authorizes collection actions, which may be debated as to practicality and impact on graduates.