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Bill

HB 2145

RELATING TO INSURANCE COVERAGE OF PROTON BEAM THERAPY.

2026 Regular Session Introduced by Gregg Takayama

Hawaii bill mandates health insurance coverage of proton beam therapy for cancer treatment, increasing costs but potentially improving outcomes for select patients with reduced radiation side effects.

Referred to HLT, CPC, referral sheet 5
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Bill Summary · HB 2145

Legislative bill overview

HB 2145 requires health insurance plans in Hawaii to cover proton beam therapy (PBT), an advanced form of radiation treatment for cancer. The bill mandates insurance coverage for this technology, which is more precise than conventional radiation therapy but significantly more expensive.

Why is this important

Proton beam therapy can reduce radiation exposure to healthy tissue surrounding tumors, potentially decreasing side effects and improving outcomes for certain cancer patients. However, this mandate directly impacts insurance premiums and healthcare costs, as PBT facilities are expensive to build and operate, and treatment costs substantially exceed conventional radiation therapy.

Potential points of contention

  • Cost implications: PBT can cost 2-3 times more than conventional radiation therapy, raising concerns about premium increases for all insured individuals to cover a treatment used by a small patient population
  • Clinical evidence threshold: Medical consensus on which cancer types definitively benefit from PBT versus conventional therapy remains evolving; mandate may require coverage for cases where evidence is still developing
  • Access and equity: Hawaii has limited PBT facilities, meaning many patients may still need out-of-state treatment despite insurance coverage, raising questions about whether a mandate addresses practical access barriers

Compiled from official sources — confirm details with the bill’s official record.

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