Do you want to get fertility treatments in Hawaii? If you’re married, there’s a good chance that the treatments will be covered by insurance.
But if you’re not married, you’re probably out of luck.
Insurance companies in Hawaii are only required to cover fertility treatment for married women, not for their single counterparts. And treatments must use sperm from the patient’s spouse.
Piilani Smith, a Native Hawaiian hula practitioner who also happens to be single, sought to change that law, saying it discriminates against all varieties of unmarried women including Native Hawaiians, who historically did not observe marriage in the traditional Western sense.
"In Hawaiian culture, there’s nothing sacred about the institution of marriage," Smith said. "It doesn’t exist. What exists is the respect for family, and ultimately ancestral genealogy."
But a push in the Legislature to expand coverage for fertility treatments to unmarried women died Thursday with the end of the session.
Hawaii is one of 15 states that have insurance mandates for fertility treatments. And the state is not alone in excluding single women from the benefit. Maryland has a similar law, according to Resolve, an organization that tracks fertility policies.
"The goal here is to not cover people," said Barbara Collura, president and CEO of Resolve. "The goal here is to exclude as many people as possible, so that your actual coverage is pretty minimal.
Smith helped craft legislation during the 2014 session that sought to expand the classes of women that are left out of the insurance mandate. Two bills were introduced that sought to expand the mandate, but both proposals died. Then she pushed for a resolution that asked the state auditor to study the possibility of expanding the insurance mandate, but that also failed.
"If it can’t be offered to everybody in a non-discriminatory manner, than repeal it," Smith said. "Because it’s a bad law, and it’s the wrong message to be sending to families."