Vaping, mental health, and prescription drug costs on the Hawaii Legislature’s agenda for 2020

Health care has emerged as a key issue for lawmakers during Hawaii’s 2020 legislative session. From vaping and mental health, to prescription drug cost transparency, here are several of the health-related bills we’re tracking this year. 


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Vaping & Tobacco Use

HB 2457: This bill would ban the sale of flavored e-cigarette products and impose a $500 – $2000 penalty fine for retailers in violation of the ban. Beginning January 1, 2021, HB 2457 would ban the sale of all flavored tobacco products, and make it unlawful to advertise or promote smoking devices “in a manner that is designed to appeal to an individual under twenty-one years of age.” 

The bill also authorizes teachers in public schools to confiscate e-cigarettes from students under the age of 21, and directs the Department of Education to establish a program for individuals under 21 to dispose of e-cigarettes in their possession. 

According to the bill, 16% of middle school students and over 25% of high school students use e-cigarettes in Hawaii. 

“Adding flavoring to tobacco changes the taste and reduces the harshness of the otherwise unflavored tobacco product, making smoking more appealing and easier for beginners to try— and ultimately become addicted. According to a recent survey, eighty-one percent of youth who have ever used a tobacco product reported that the first tobacco product they used was flavored,” reads the bill. 

HB 2457 passed out of both the House Health Committee and the House Lower & Higher Education Committee on Tuesday. 

SB 2227: This bill, which passed out of the Commerce, Consumer Protection, and Health Committee on Wednesday,  would add electronic smoking devices to the definition of “tobacco products” that is currently used in the state’s cigarette tax and tobacco tax law. This would result in an excise tax on e-cigarettes, and would require vaping companies to obtain a license through the Department of Taxation. The bill would also increase the licensing fee and the retail tobacco permit fee for retailers. After Jun 30, 2020, $2 million in collected fees would go toward funding health education, prevention, and cessation programs to reduce the use of e-smoking devices among youth. 

The legislation states: “Taxing the sale of these products, as the state does the sale of other tobacco, is fair and equitable. Imposing a sales tax on e-cigarettes will also encourage users of e-cigarettes to quit, sustain cessation, prevent youth initiation, and reduce consumption among those who continue to use them.”

HB 2540: This bill would progressively ban the sale of cigarettes and e-cigarettes by periodically raising the minimum age of purchase. The bill proposes raising the minimum age to purchase these products to 30 years of age by 2021, 40 years of age by 2022, 50 years of age by 2023, until finally 100 years of age by 2025. The bill passed out of the House Health Committee on Tuesday. 


Mental Health

HB 2412: This piece of legislation would require the Department of Education to develop a 3-year pilot program for the creation and implementation of a trauma-informed education program in the Castle, Kailua, and Kalaheo complexes. The bill specifies that the new programs should be based on the trauma-informed education program already in place in the Nanakuli-Waianae complex area which has seen positive results since its implementation. 

A trauma-informed program involves providing teachers, students, staff, and parents with mental health education in order to address adverse childhood experiences. The goal of the program is to create a strategy for addressing trauma and promote social and emotional learning in schools to better serve children, families, and communities. 

HB 2522: The purpose of this bill is to improve the overall behavioral health continuum of care in Hawaii. According to the bill, a recent task force report to the legislature highlighted the need “for a coordinated network of stabilization beds which will allow triage, clinical assessment, and recommendation for next level of care for those struggling with substance use, mental health conditions, and homelessness.” Currently, emergency rooms are often the only option for individuals needing stabilization. 

HB 2552 would require the Department of Health to establish short-term, residential stabilization beds throughout the state by repurposing unused state facilities. Patients would then be assessed and connected to appropriate levels of care through the Hawaii Coordinated Access Resources Entry System (CARES). 

HB 2707: This legislation aims to increase the number of mental health professionals in Hawaii through the creation of a behavioral health social worker scholarship program at the University of Hawaii. The scholarship program would assist students with tuition and fees in exchange for a 5-year commitment to work with the Department of Human Services in the areas of behavioral health. 


Prescription Drug Costs: 

On Friday, the Senate Committee on Commerce, Consumer Protection, and Health will hear a series of bills related to prescription drug cost transparency. Among those bills are SB 2226 and  SB 2280 which aim to increase the transparency of pharmacy benefit manager (PBM) operations. This would be accomplished by establishing transparency reporting requirements for PBMs, creating a licensing requirement for PBMs, and in the case of SB 2280, prohibit PBMs from engaging in “self-serving business practices.”

The committee will also discuss SB 2276 which would require drug manufacturers to provide notice if the wholesale price of certain drugs will increase by 16% or more over a 2-year period. Manufacturers would be required to report this information 60 days prior to the price increase and include information on the drug’s current costs, the dollar amount of the future price increase, and a statement on if changes or improvements to the drug necessitates the price increase.