SB1040 directs the Office of Wellness and Resilience to study whether Hawaii should create a medical debt acquisition and forgiveness program. The study must examine the cost and feasibility of buying and forgiving medical debt for certain residents, specifically households at or below 400 percent of the federal poverty level or households whose medical debt is at least 5 percent of household income. The office must also review how similar programs have worked in other states and consult with nonprofit health care systems or other organizations involved in medical debt relief.
The bill is primarily a study and reporting measure rather than an immediate debt-relief program. It requires the office to submit findings, recommendations, and any proposed legislation to the Legislature before the 2026 regular session. The act is set to take effect on December 31, 2050, which is a common delayed-effective-date structure used in Hawaii legislation and means the bill does not create an immediate operational program upon enactment.
Impact
SB1040 would not directly change medical debt collection law or create a forgiveness program by itself. Instead, it would add a new statutory duty for the Office of Wellness and Resilience to evaluate the feasibility of a state-backed medical debt acquisition and forgiveness initiative and report back to lawmakers. If the study leads to future legislation, the bill could influence how Hawaii addresses medical debt, nonprofit debt-buying partnerships, and relief for lower-income households and residents with high debt burdens.
Sentiment
The committee votes show strong support for the measure, with unanimous passage in the Senate Commerce and Consumer Protection, Health and Human Services, and Ways and Means committees, each with amendments. The bill’s findings frame medical debt as a significant public health and economic issue, and the overall tone of the discussion reflected interest in exploring a targeted relief model used in other jurisdictions. The lack of recorded opposition in the available voting history suggests broad agreement on at least studying the issue.
Contention
The main policy questions appear to be practical rather than ideological: whether a medical debt acquisition and forgiveness program is financially feasible, how eligibility should be set, and what role the state should play versus nonprofit partners. The bill’s findings emphasize benefits to patients, hospitals, and community well-being, but the study requirement indicates lawmakers had not yet committed to creating the program itself. Any future debate is likely to focus on cost, administrative structure, the income and debt thresholds, and whether the state should pursue debt purchase and cancellation as a public policy tool.
A resolution to direct the Clerk of the House of Representatives to only present to the Governor enrolled House bills finally passed by both houses of the One Hundred Third Legislature.
Relating to nonsubstantive additions to, revisions of, and corrections in enacted codes, to the nonsubstantive codification or disposition of various laws omitted from enacted codes, and to conforming codifications enacted by the 88th Legislature to other Acts of that legislature.