- Tara Brandner
Support Legislation Requiring Insurers to Support Infertility Care
This guest post was submitted by Tara Brandner, a doctorate nurse practitioner, infertility patient, and primary constituent behind SB 2233. She has also created a Facebook page to share information about the legislation.
One in eight individuals or couples, and over 14,000 North Dakota Residents, have trouble getting pregnant or sustaining a pregnancy.
The American Medical Association, American Congress of Obstetricians and Gynecologists and the World Health Organization recognize infertility as a disease, which means it should be covered by health insurance like other diseases. Senate Bill 2233 requires insurance companies to provide infertility care coverage and cancer preservation. This is a bipartisan issue about helping North Dakota families. Currently, 16 states have laws regarding insurance coverage for infertility diagnosis or treatment.
Long-term cost savings outweigh the short-term savings of not providing coverage. Studies show that patients in states without IVF insurance mandates had higher multiple pregnancy rates due to transferring significantly more embryos per cycle than states with coverage. Preterm birth, low birthweight, and high rates of disability are common and expensive complications of multiple births.
Senate Bill 2233 requires insurance companies to provide infertility care coverage and cancer preservation. This is a bipartisan issue about helping North Dakota families.
Cost is the number one barrier to care. A recent survey found that women (25-34 years old) accrued $30,000 of debt on average after undergoing infertility treatment. A national infertility organization, Resolve, completed a community survey that found 39% of participants used credit cards to pay for their fertility procedures, while 12.6% took out loans and 4% used their home as equity
The Center for Disease (CDC) reported that only one in three women who seek infertility services require treatment beyond basic medical advice. Of those patients seeking infertility services, only 7% utilize intrauterine insemination (IUI) and 3% utilize in vitro fertilization (IVF). A low percentage of patients diagnosed with infertility actually require more intensive intervention. At this point when a health care provider diagnosis a patient with the ICD 10 code of infertility every lab draw, ultrasound, medication, and procedure is paid for out of pocket by the patient.
Additionally, infertility patients will encounter highly inflated managed care pharmacy prices for medications, where patients with coverage can pay as much as 100% more for medications compared to prices charged to self-pay patients. These inflated prices often contribute to 25-50% or more of total infertility costs, which can quickly drain insurance lifetime caps and severely limit overall care options.
Fertility preservation services provide patients at risk of iatrogenic, or medically-induced infertility with the potential ability to conceive children following treatments that may damage reproductive tissue. Examples of this include surgery, radiation, chemotherapy, and prescription drugs. In order to preserve reproductive capabilities, fertility preservation services would be decided upon prior to disease treatment. Loss of fertility can negatively impact the quality of life for patients of reproductive age who are treated for cancer.
Unlike chronic diseases that are very costly in a lifetime, infertility patients will utilize fertility coverage or cancer preservations only during their reproductive years. Imagine your life without your children, grandchildren, nieces, nephews, or any child whom you are close with. It’s unimaginable. The time has come to support these patients longing for families and provide insurance for infertility care and cancer preservation. If you have never experienced this journey think of it this way.
Struggling with infertility is like dealing with the five stages of grief every single month waiting for that positive test result. You deny, bargain, get angry, cry, and accept. Then you pick yourself back up and do it all over again.