Pas Trustednews – Bill Aims to Increase Insurance Coverage for Fertility Treatment

Infertility challenges are thought to affect as many as 1 in 5 women, according to the CDC. But fertility treatments like in vitro fertilization (IVF) are still out of reach for millions, as most insurance plans and employers don’t offer coverage—or if they do, it’s far from comprehensive. But infertility care is healthcare, too. “The ability to have a family should not be denied to anyone on account of a lack of insurance coverage for medically necessary treatment,” states the text of a reintroduced bipartisan bill known as The Access to Infertility Treatment and Care Act.

Sponsored by Representative Rosa DeLauro (D-CT) and Senator Cory Booker (D-NJ), the bill would require more health insurers to provide coverage for fertility treatment along with fertility preservation services for individuals who undergo medically necessary procedures that may result in infertility, like chemotherapy or hormone therapy.

Just 27% of large employers and 14% of small employers offer insurance coverage for IVF. Out-of-pocket costs can easily exceed $10,000—per cycle.

The cost of fertility treatment is a huge burden

On top of the emotional stress of fertility treatment, the financial stress of being able to afford it places a huge burden on patients. A 2023 survey from Maven Clinic found that 66% of patients said they wish they knew the full cost of fertility treatment before they began the process to better prepare them for what to expect. But even after a visit to a fertility clinic, 49% of people said that the biggest questions they faced about their fertility treatment was how they were going to afford it.

Paying for fertility treatment may mean cutting back on other spending. While 51% of people said they had to forgo putting money into savings to pay for fertility treatment, another 46% said they paused on home renovations and repairs, and 36% had to trim back everyday expenses, like groceries or transportation.

“A single IVF cycle can cost up to $38,015—an amount of money most American families cannot afford. And that’s not all; there are hidden costs for testing, lab fees, storage fees, and medications, which typical health insurance doesn’t cover,” shares Sylvia Kang, CEO and Founder of women’s health company Mira. “Insurance coverage becomes even more complicated when a person becomes infertile due to a medical treatment or procedure, such as chemotherapy or radiology. As a result, people with complex medical conditions are left with the emotional and physical burden of infertility and mounting financial debt.”

“But there are ways to make the fertility industry more accessible for everyone,” Kang continues. “And I am hopeful that the Access to Infertility Treatment and Care Act will ensure that more Americans get the insurance coverage they deserve to plan their families, regardless of their medical history or financial status.”

What will the Access to Infertility Treatment and Care Act do?

The Access to Infertility Treatment and Care Act would:

  • Require most private health insurance plans, as well as plans offered by the Federal Employees Health Benefits Program, Medicaid, TRICARE, ERISA, and the VA, to provide coverage for treatment of infertility without raising insurance or copayment costs.
  • Ensure these plans cover fertility preservation services for individuals who undergo a medically necessary procedure that may cause infertility.

Though PCOS is one of the most frequent causes of infertility, treatment can help those with the condition get pregnant. But if costs are out of reach, it makes family building untenable for many.

“Insurance often covers the diagnosis of infertility but not the treatment,” said Sasha Ottey, MHA, MT (ASCP), Executive Director of PCOS Challenge: The National Polycystic Ovary Syndrome Association, in a statement. “This discriminatory practice has rendered infertility treatments unaffordable for many families and severely impacts their financial futures as well as their ability to have children. We commend this effort to increase access to much-needed infertility care for everyone diagnosed with infertility.”

Those on public insurance such as Medicaid or government-sponsored plans like TRICARE and the VA should also be able to more broadly access this important healthcare. “Cost should never be a barrier to growing your family, but for many military members, it is. TRICARE, the military health benefit, does not cover infertility treatment, which makes family planning impossible for those in uniform and their loved ones navigating deployments, trainings, and their duty to our nation,” said Besa Pinchotti, CEO of National Military Family Association, in a statement.

How to support the bill

In order to support this critical policy change that would allow everyone broad access to medical care for family building, reach out to your legislator to ask them to cosponsor the bill. RESOLVE: The National Infertility Association offers a customizable form letter on their website to take quick action.

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