SB838 would require most health insurance policies, hospital and medical service plans, and health maintenance organization coverage in Hawaii to cover continuous glucose monitors (CGMs) and related supplies for people diagnosed with diabetes, including gestational diabetes, whether or not they use insulin. Coverage would apply only when the device is medically necessary and prescribed by an authorized health care professional, and it would also include necessary repairs or replacement parts. The bill preserves existing diabetes self-management training and supply coverage while adding a new mandated benefit for CGMs.
The measure is aimed at expanding access to diabetes management technology, especially for rural and high-risk communities, and is framed as a health equity and cost-reduction measure. It excludes Medicaid managed care programs and limited benefit health insurance from the new mandate. The bill also authorizes the Department of Health to accept gifts, grants, and donations to support expanded CGM access.
Impact
SB838 would amend Hawaii’s insurance code, including section 431:10A-121 and section 432:1-612, and would align HMO coverage requirements under section 432D-23 with the new CGM mandate. In practical terms, insurers issuing or renewing covered policies after December 31, 2025 would have to include CGM coverage for eligible enrollees with diabetes, subject to the bill’s medical-necessity and prescription requirements and cost-sharing limits comparable to other covered medical services. The bill would not apply to Medicaid managed care programs, and it would allow the Department of Health to seek outside funding to expand access. Although the bill’s general effective date is July 1, 2050, the coverage provisions are set to apply to policies renewed or issued after December 31, 2025.
Sentiment
The overall sentiment appears supportive. The bill passed the Senate Health and Human Services Committee unanimously and also passed the Senate Commerce and Consumer Protection Committee unanimously, both with amendments. The findings section emphasizes rural health needs, diabetes prevalence, and improved outcomes from CGM use, suggesting broad policy support for expanding coverage. The later recommendation to defer by the HLT committee indicates the measure was not yet ready to advance at that stage, but the recorded votes show no opposition in committee.
Contention
The main policy issues appear to be the scope and cost of the insurance mandate, including which plans are covered, how the benefit is structured, and whether cost-sharing can be imposed. The bill specifically excludes Medicaid managed care and limited benefit plans, which may reflect concern about program design and fiscal impact. Another point of potential contention is the open-ended minimum-benefit language in the bill text, which contains blanks for the required benefit amount and coverage period, suggesting unresolved details. Insurers and budget-focused stakeholders would likely be most concerned about premium impacts, while diabetes advocates and rural health supporters would favor the expanded access.