Hawaii releases first comprehensive guide to abortion care

People seeking abortions in Hawai‘i now have access to a first-of-its-kind guide to abortion care, compiled by the Hawai‘i Abortion Collective (HAC). Last week, members of the newly-formed coalition, including the Hawai‘i State Commission on the Status of Women, Planned Parenthood, and the Healthy Mothers Healthy Babies Coalition of Hawai‘i, announced the guide’s creation at a press conference at the Hawai‘i State Capitol. 

 

Get the latest state-specific policy intelligence for the health care sector delivered to your inbox.

 

When the US Supreme Court overturned Roe v. Wade in June, leaving abortion policy up to the states, abortion remained legal in Hawai‘i under the State Constitution and state laws in the Hawai‘i Revises Statues passed by the Hawai‘i State Legislature. However, the ruling is causing confusion and raising caution among providers and those seeking abortions across the country. Additionally, abortion is not accessible for everyone, such as those who are underinsured or uninsured or live on islands with few abortion providers. 

“We hope that this guide, put together by the Hawai‘i Abortion Collective, helps combat the misinformation that is so prevalent online and in the community, so that everyone knows abortion in Hawai‘i is legal, safe, and available,” Tracy Chen, MD, an OB/GYN at the Queen’s Health System, said at the press conference. 

The abortion guide, which HAC notes is subject to change over time and with community input, lists information about the legality of abortion in Hawai‘i, how to access abortion care regardless of insurance standing, and other wellness resources. 

The guide explicitly states several provisions: 

  • It is legal to leave Hawai‘i to get an abortion out of state. 
  • The decision of when to have an abortion should be a private decision between the patient and their health care provider.
  • Those seeking an abortion can ask their insurance carrier to keep the procedure information confidential from others if they are under a partner or family plan.
  • Minors under 18 can consent to an abortion if they are at least 14 years old, and can request their insurance to keep the procedure and other information private from parents or guardians. 

The guide describes different abortion methods and the recommended procedure based on the person’s pregnancy. For example, it explains that medication abortions (pills or oral medication) are available up to 11 weeks after the start of a person’s last menstrual period. 

It also offers guidance on how abortion care is covered based on your ability to pay. According to the guide, in-clinic abortions typically cost $850 up to 12 weeks’ gestation, $950 between 12-14 weeks, and $1,050-$1,539 after more than 14 weeks. 

Most private insurance companies, such as HMSA, AlohaCare, and Kaiser, provide coverage for both medication and aspiration abortion, while federal insurance, such as Tricare/Triwest, will not cover abortion, except in cases of rape, incest, or the if the pregnant person’s life is at risk. 

Med-QUEST, the state Medicaid program, also provides coverage for abortion care, as well as coordination for transportation to a neighbor island if there are no providers on the patient’s island. 

If a patient is not insured, the guide encourages them to apply for Med-QUEST, or reach out to one of several local and community-based abortion funds. These funds include the Reproductive Justice Fund at the University of Hawai‘i’s Women’s Options Center, the Hawai‘i Abortion Fund from grassroots organization AF3IRM Hawai‘i, and national abortion funds

The guide also provides information about legal resources, abortion doulas, wellness services community health centers, support for survivors of sexual assault and domestic violence, and resources for the LGBTQIA+ community (such as clinics that specifically focus on transgender care and LGBTQIA + support). 

Abortion supporters in Hawai‘i warn that although abortion remains protected in the state, it must work to expand protections. 

“[Guam] recently introduced in their legislature a bill similar to Texas’s SB 8,”  Reni Soon, MD, Chair of the American College of Obstetricians and Gynecologists Hawai‘i Section, previously told State of Reform. “[Guam] has been without an abortion provider for 4 years now. We do get a handful of patients from Guam every month. That may or may not increase [post-Roe v. Wade].”

Rep. Linda Ichiyama (D – Moanalua Valley), who spoke at the HAC press conference, also plans to continue strengthening abortion care in the next legislative session. Last year, the legislature passed a bill allowing advanced practice registered nurses to provide abortion care. Going forward, Ichiyama said training enough providers, especially in islands with no abortion providers, is key to expanding access to care in the state.