Hawaii House Bill HB221

Hawaii 2026 Regular Session

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

Caption

RELATING TO MEDICAL SCHOOL TUITION.

Summary

HB221 would create a new statutory requirement for graduates of the University of Hawaii John A. Burns School of Medicine (JABSOM) who paid Hawaii resident tuition and receive their M.D. after January 1, 2029. Covered graduates would be required to begin practicing medicine in Hawaii within five years after completing residency or fellowship, and then remain in the state for at least two consecutive years. The bill is aimed at addressing Hawaii’s physician shortage by tying the benefit of subsidized resident tuition to a service commitment in the state. If a covered graduate does not begin practicing in Hawaii on time, or does not complete the two-year service period, the bill requires reimbursement to the state for the difference between resident and nonresident tuition for each year the person paid resident tuition. The University of Hawaii would be responsible for monitoring compliance, enforcing repayment, and may contract with public or private entities, including collection agencies, to recover amounts owed. The bill also requires annual reporting to the Legislature beginning in 2036 on compliance, progress, reimbursements, and any exemptions granted.

Impact

HB221 would add a new subpart to Chapter 304A, Hawaii Revised Statutes, creating a tuition-linked service obligation specifically for JABSOM resident-tuition recipients graduating in 2029 or later. It would impose a new repayment liability for noncompliance, authorize administrative enforcement by the University of Hawaii, and require annual legislative reporting. The measure would affect medical students, JABSOM graduates, the University of Hawaii, and the state’s broader physician workforce pipeline.

Sentiment

The bill’s stated purpose and framing suggest generally supportive sentiment around improving Hawaii’s physician retention and ensuring a return on public investment in medical education. The bill relies on findings that Hawaii has a large physician shortage and that graduates who complete residency in Hawaii are more likely to remain in the state. No committee transcript or vote record was provided, so there is no documented recorded debate or formal vote sentiment in the available materials.

Contention

The main policy tension is between workforce retention goals and the burden placed on medical students and graduates. Supporters are likely to view the service requirement as a fair exchange for subsidized resident tuition and a practical response to physician shortages. Potential concerns include whether the mandate could discourage applicants, create financial hardship through repayment obligations, or be difficult to enforce, especially for graduates who leave the state or face personal or professional extenuating circumstances. The bill addresses some of these concerns by allowing the dean to grant exemptions or extend the service deadline for extenuating circumstances.