Cancer care in Hawaiʻi continues to see wins this week with Thursday’s signing ceremony for both House Bill 1969 and HB 1864 at the Hawaiʻi State Capitol.
(ICYMI: On Monday, the University of Hawaiʻi Cancer Center unveiled its Hoʻōla Early Phase Clinical Research Center, the state’s first dedicated center for early phase cancer clinical trials.)
HB 1969, which became a law effective July 1, appropriates $1.8 million over the next fiscal year to the Department of Human Services to offer colorectal cancer screenings and treatments for individuals who are uninsured, underinsured, or otherwise ineligible for Medicare. The measure also requires health insurance plans to cover medically necessary follow-up colonoscopies after a positive colorectal cancer screening test without deductibles, copayments, coinsurance or other cost-sharing, per the Governor’s Office.
Officials say the passage of this bill comes at a crucial time as colorectal cancer cases and deaths continue to rise, especially among young adults statewide.
“Governor Green’s signing of HB 1969 into law makes Hawaiʻi an innovative leader for colorectal cancer screening and treatment,” said Dr. Shane Morita, surgical oncologist, American Cancer Society (ACS) medical officer and American Cancer Society Cancer Action Network (ACS CAN) volunteer. “Colorectal cancer is often curable when detected early, yet it remains a major cause of cancer-related death in Hawaiʻi. Expanding access will reduce the burden on local families and improve survival for our patients.”
According to the American Cancer Society, colorectal cancer is now the No. 1 cause of cancer-related deaths for adults under 50 and is the second-leading cause of cancer deaths in Hawaiʻi for both men and women.
In the Islands alone, roughly 840 residents will be diagnosed with the disease and 240 will die this year, ACS estimates, adding that cases among people younger than 50 are rising with incidence nearly 3.5% annually from 2013 to 2022, per the Hawaiʻi Tumor Registry.
“Colorectal cancer is one of the most preventable and treatable cancers when detected early,” said Rep. Cory Chun, who introduced HB 1969 during the 2026 legislative session. According to him, Sen. Rosalyn Baker, among other lawmakers and advocates, first began working on the policy in 2012.
“My family has also been touched by cancer. Before I became the representative for District 35, (which includes portions of Pearl City, Waipahu, and Crestview), I was working at the American Cancer Society,” he told Aloha State Daily. “In the last 10 years, we’ve seen a rise in colorectal cancer cases under the age of 50, actually, under the age of 40. ... We don’t quite know yet the reason why that’s happening and we don’t have a cure. So, the best way we can save people’s lives is to detect it early.”
Adults should begin regular colorectal cancer screening at age 45, per guidelines from ACS and Centers for Disease Control and Prevention. Those with a family history of colorectal cancer, should begin screening 10 years earlier than the youngest affected relative's diagnosis, or at age 35, whichever comes first.
“There are other less invasive ways to screen than a colonoscopy such as stool-based tests, and this new law includes coverage for follow-up treatments, as well,” Chun said. “If you feel like something is not right in your body, go get it checked out. Don’t wait.”
ACS officials say, “Cost and lack of insurance are major barriers to getting recommended screenings. For those without insurance, cost remains a significant obstacle. The passage of HB 1969 is a major step toward addressing the cancer burden in Hawaiʻi.”
Mark Vasconcellos is a two-time cancer survivor and longtime volunteer for ACS CAN, the 501(c)(4) advocacy arm of ACS, a 501(c)(3), who credits his life today to early detection, his local doctors, and those he serves alongside including Chun and ACS CAN Hawaiʻi government relations director, Cynthia Au.
“I want to thank them for keeping me alive,” he told ASD.
Twelve years ago, Vasconcellos was first diagnosed with Hodgkin lymphoma and breast cancer, and shortly after discovered he had stage 1 colorectal cancer, which was treated by chemotherapy, radiation and a non-invasive surgical procedure.
“I didn’t have any symptoms, but Hawaiʻi Pacific Health, where I received my cancer care, sent me a reminder about getting a colonoscopy by age 50. I listened and went in for a screening and was glad that I did.”
When asked about what this new law means for him and others, Vasconcellos told ASD, “It’s a very happy moment and is long overdue. We’re going to be able to help everyone going forward, giving them a greater chance of survival and a longer life where they can spend more holidays with their loved ones. Life is too short.”
Vasconcellos, who was born and raised in Kaimukī and now resides in ʻAiea, works for a rental car company and volunteers with ACS CAN Hawaiʻi to help educate the community about cancer. He says after beating cancer, he went to eat and celebrate with his friends.
“I’m looking forward to growing our volunteer base (for ACS CAN Hawaiʻi) and sharing more information about colorectal screenings and treatments, especially with younger people. Our message to them is to take care of yourself!”
More on HB 1969 and HB 1864
Gov. Josh Green, who was formerly a physician on the Big Island, was smiling as he signed multiple health-related bills into law Thursday, July 9, including HB 1969 and HB 1864.
At the first bill signing ceremony of the day, ASD asked him which insurers would be participating in the program and how patients could opt-in or find more details.
“Everybody participates,” Green said. “We also are mindful that people already have plans they’re engaged with, whether that’s HMSA, Kaiser, Aloha Care, etc. It’s gotta be comfortable. We want it to be very straightforward and simple for people. So, we’ll put out a lot of announcements through the Department of Health of how you can make sure you access this."
He continued, “The big picture is that we want everyone to know that their screening for colorectal cancer is covered. It just takes a little bit of time now through the end of the year to update all the plans. But they were very aware, understood this was necessary and that it’s a good thing.”
Rep. Gregg Takayama, chair of the House Health Committee, added: “HB 1969 further covers persons who do not have access to health insurance. That’s key … because we expect many more people will lose health insurance coverage under Medicare in the coming years. Most of the health plans already provide for colorectal cancer screenings. This add uninsured patients to them.”
Green noted, “This is the safety net. I would not be surprised if we don’t create a whole series of safety nets to give people direct access to care as we go through this era where Medicaid is restricted somewhat.”
“There is also chatter around what will happen if the health care system consolidates. We are going to insist that these kinds of services remain part of any program,” he said.
ASD also asked Green if staffing is in place to be able to accommodate new or existing cancer patients.
“We always have challenges, especially in our rural communities, but that is another part of it. We’re going to make sure people get direct access and if they have to get over to Oʻahu for specialized care, we will make that available, too,”
He credited a few programs in place already to augment Hawaiʻi’s health care workforce: The Health Education Loan Forgiveness, or HELP, Program funded by the state and HOME RUN (Hawaiʻi Outreach For Medical Education in Rural Under-resourced Neighborhoods), which is a workforce pipeline initiative under Hawaiʻi's Rural Health Transformation Plan, "intended to repay debts and give extra access in areas outside of urban Honolulu." Green said.
“So, we’re going to be recruiting and recruiting and recruiting, as we have done in the last couple years. Primary care providers for screening. Specialty care providers for the actual treatments,” Green notes. “My hope is over the course of the next six years, we’ve come to a functional zero of shortage for health care providers. We also have enhanced the capacity for Nurse Practitioners and Physician Assistants to do a lot of the additional care, in this case screening.”
Green also commended the Healthcare Association of Hawaiʻiʻs efforts to build a local workforce pipeline that gets students interested in joining the health care field.
In brief, the state’s plan according to him is to “train kids early to get the interested in health care. We pay debt so people can afford to be health care providers. Make sure the plans or the state cover any extra screening … and the endgame: having specialists help those 2,500 people who [die of cancer every year in the state]."
Also related to cancer, HB 1864 requires insurers to cover standard fertility preservation services for individuals undergoing medically necessary treatment — like chemotherapy, radiation, surgery, or hormone therapy — that may cause iatrogenic infertility. This measure makes Hawai‘i the 22nd state to ensure that residents can build a family, while receiving life-saving medical treatment.
“This is a historic moment for many of Hawaiʻi’s young cancer patients who, until now, not only had the heartache of receiving the devastating news of a cancer diagnosis, but also had the painful realization that the treatment for their cancer would result in the permanent inability for future fertility,” said Dr. Michael Carney, chair of Hawaiʻi Society for Clinical Oncologists, at the bill signing. “This law that we have worked so hard over so many years to pass, is now reality and these cancer patients can have at least a small part of their cancer journey improved. Hawaiʻi has now mandated the option of the initial protection for future fertility in these cancer survivors — hope for survival and genuine hope for a future family.”
In a second bill-signing ceremony today, Green signed Senate Bill 3025, (Act 220), which establishes a framework to relieve medical debt up to $91 million in total for as many as 50,000 Hawaiʻi. The measure requires the Office of Wellness and Resilience, now under DHS, to create and administer a Medical Debt Acquisition and Forgiveness Program to purchase and eliminate outstanding medical debt for state residents, contingent on available program funds, per the Governor’s Office.
For more information on colorectal cancer screening in Hawaiʻi, visit livinghealthy.hawaii.gov/get-screened.
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Kelsey Kukaua Medeiros can be reached at kelsey@alohastatedaily.com.
