Hawaii Takes a Stand for Privacy: HCR 144/HR 138 Calls for Investigation of Crisis Pregnancy Centers

by Rindala Alajaji, Electronic Frontier Foundation, March 11, 2025 

(EFF founded in 1990 funded by Silicon Valley billionaires.)

In a bold push for medical privacy, Hawaii's House of Representatives has introduced HCR 144/HR 138, a resolution calling for the Hawaii Attorney General to investigate whether crisis pregnancy centers (CPCs) are violating patient privacy laws. 

Often referred to as "fake clinics" or “unregulated pregnancy centers” (UPCs), these are non-medical centers that provide  free pregnancy tests and counseling, but typically do not offer essential reproductive care like abortion or contraception. In Hawaii, these centers outnumber actual clinics offering abortion and reproductive healthcare. In fact, the first CPC in the United States was opened in Hawaii in 1967 by Robert Pearson, who then founded the Pearson Foundation, a St. Louis-based organization to assist local groups in setting up unregulated crisis pregnancy centers. 

EFF has called on state AGs to investigate CPCs across the country. In particular, we are concerned that many centers have misrepresented their privacy practices, including suggesting that patient information is protected by HIPAA when it may not be. In January, EFF contacted attorneys general in Florida, Texas, Arkansas, and Missouri asking them to identify and hold accountable CPCs that engage in deceptive practices.

Rep. Kapela’s resolution specifically references EFF’s call on state Attorneys General. It reads:

“WHEREAS, the Electronic Frontiers (sic) Foundation, an international digital rights nonprofit that promotes internet civil liberties, has called on states to investigate whether crisis pregnancy centers are complying with patient privacy regulations with regard to the retention and use of collected patient data.” 

HCR 144/HR 138 underscores the need to ensure that healthcare providers handle personal data, particularly medical data, securely and transparently.. Along with EFF’s letters to state AGs, the resolution refers to the increasing body of research on the topic, such as: 

A 2024 Healthcare Management Associates Study showed that CPCs received $400 million in federal funding between 2017 and 2023, with little oversight from regulators.

A Health Affairs article from November 2024 titled "Addressing the HIPAA Blind Spot for Crisis Pregnancy Centers" noted that crisis pregnancy centers often invoke the Health Insurance Portability and Accountability Act (HIPAA) to collect personal information from clients.

Regardless of one's stance on reproductive healthcare, there is one principle that should be universally accepted: the right to privacy. As HCR 144/HR 138 moves forward, it is imperative that Hawaii's Attorney General investigate whether CPCs are complying with privacy regulations and take action, if necessary, to protect the privacy rights of individuals seeking reproductive healthcare in Hawaii. 

Without comprehensive privacy laws that offer individuals a private right of action, state authorities must be the front line in safeguarding the privacy of their constituents. As we continue to advocate for stronger privacy protections nationwide, we encourage lawmakers and advocates in other states to follow Hawaii's lead and take action to protect the medical privacy rights of all of their constituents.

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2017: Hawaii pro-life centers fight abortion referral mandate

HCR 144: Text, Status

HR 138: Text, Status