SB3045 requires health insurance coverage in Hawaii for continuous glucose monitors (CGMs) and related supplies for people diagnosed with diabetes, including gestational diabetes, whether or not they use insulin. The bill amends the state’s insurance and health plan statutes so that individual and group accident and health policies, hospital and medical service plan contracts, and the corresponding HMO benefit provisions must cover medically necessary CGMs prescribed by an authorized health care professional. Coverage must also include necessary repairs or replacement parts, and cost-sharing may be applied only on terms no less favorable than those for comparable covered medical services, equipment, or supplies.
The bill applies to policies and plans issued or renewed after December 31, 2026, and it expressly extends to Medicaid managed care plans, subject to federal approval and any needed waivers. It also directs the Department of Human Services to seek federal authorization to implement the Medicaid portion and allows the Department of Health and DHS to accept gifts, grants, and donations to support expanded access to CGMs. The measure is framed as a cost-saving and care-improving response to diabetes-related complications, especially in rural, neighbor island, and medically underserved communities.
Impact
SB3045 expands mandated diabetes coverage under Hawaii Revised Statutes sections 431:10A-121 and 432:1-612, and aligns HMO coverage under section 432D-23 with the new CGM requirement. It creates a statewide insurance mandate for CGMs and related supplies, affecting commercial insurers, mutual benefit societies, health maintenance organizations, and Medicaid managed care programs. The bill also preserves existing diabetes self-management training and supply coverage while adding a new, specific benefit for CGMs, with implementation beginning for most plans on policies issued or renewed after December 31, 2026.
Sentiment
The bill appears to have broad support and little recorded opposition. It passed Senate Health and Human Services, Senate Commerce and Consumer Protection, and the House and Senate conference votes unanimously or near-unanimously, and it was enrolled to the Governor. The discussion reflected a generally favorable view of CGMs as evidence-based tools that improve diabetes management, reduce acute care use, and promote more consistent coverage across insurers and public programs.
Contention
The main policy issues are implementation and scope rather than outright opposition. The most notable points are the mandate’s extension to Medicaid managed care, which requires federal approval and waivers, and the requirement that insurers cover CGMs regardless of insulin use, which broadens eligibility beyond some existing coverage standards. There is also a limited carve-out for certain limited-benefit health insurance policies, and the bill allows standard cost-sharing so long as it is not less favorable than for comparable benefits. No major committee disagreement is reflected in the available record.