RELATING TO HEALTH CARE.

Updated the bill version from House Draft 2 (HD2) to Senate Draft 1 (SD1) and changed the listed author names from Emma Berman to Fredrick Akau and Ainoa Naniole.

Corrected a reference to the 2023 privacy law by changing 'Session Laws of Hawaii 2023,' to 'Session Laws of Hawaii 2023 (Act 2),' for grammatical consistency.

Changed the effective date of the Act from July 1, 3000, to 'upon its approval,' allowing the law to take effect immediately after signing.

Added explicit protection for gender-affirming health care services to prevent abusive litigation and insurance discrimination, matching the protections already afforded to reproductive health care.

Updated the definition of 'gender-affirming health care services' from a detailed list of specific interventions to a broader standard of any medically necessary service respecting a patient's gender identity.

Removed the specific exclusion of pregnancy termination from the definition of 'reproductive health care services,' broadening the scope of protected reproductive care.

Revised language regarding disciplinary actions and criminal convictions to ensure they do not apply when based on providing lawful gender-affirming or reproductive health care in accordance with Hawaii law.

Clarified that medical malpractice insurers must not take adverse actions like rate increases or policy renewals based solely on a provider offering lawful reproductive or gender-affirming care.

The effective date of the Act was changed from July 1, 2026, to July 1, 3000, significantly delaying when the protections go into effect.

The list of prohibited actions by health insurers was modified to remove 'rate increases' as a standalone prohibited action, implying that rate increases based on sound actuarial principles are now allowed, and to clarify that other penalties must not be based on sound actuarial principles.

Minor text corrections were made, including fixing the word order in a clause about federal and state agencies and adjusting formatting around the definition of prohibited actions.