It’s now time for Washington State to require insurers to cover infertility treatment

It’s likely we all know someone who is struggling with the devastating effects of infertility. A disease that affects 1 in 8, infertility knows no boundaries of geography, gender, race, religion or sexual orientation.

In addition, young men and women diagnosed with cancer are often at risk for medically-related infertility and have a narrow window to access fertility preservation before beginning their cancer treatments.

Twenty states today have insurance laws for infertility medical care. It may seem surprising given its reputation as the steadfast vanguard for protecting access to reproductive health, but Washington state is not one of those states.

Because our state does not mandate health plans to cover infertility treatments, the ability to raise a family becomes a function of economic privilege for those facing an infertility diagnosis. Washingtonians who pay monthly premiums for their health insurance but do not have fertility coverage bear the entire cost of their infertility medical care themselves, adding financial stress and debt to the already significant emotional drain of infertility.

Many simply cannot afford care. Others drop out of treatment early when their savings are depleted.

The status quo in our state disproportionately affects people of color, the less affluent, and those providing basic services such as day care. B. School teachers whose health plans do not cover infertility treatment. It discriminates against the LGTBQ community and others who need medical assistance to have children.

Lawmakers in Olympia are now introducing a much-needed bill (HB 1151) to address the inequalities, untreated burdens of disease and injustices that have existed unchecked in our state for far too long. HB 1151 is widely supported by patient advocates and health professional organizations statewide and would require insurers to pay for infertility medical care and fertility preservation for patients diagnosed with cancer or other conditions that affect fertility can.

Studies make it clear that mandatory health insurance not only improves access, but also leads to better treatment outcomes. Most patients diagnosed with infertility do not require or undergo IVF treatment. For those who require IVF and have insurance coverage, the rate of higher-risk multiple pregnancies is lower because patients are more likely to choose single embryo transfer. This translates into significant cost savings as well as better health outcomes for both mother and child.

What HB 1151 won’t do is significantly increase premiums for Washingtoners. Robust data and actuarial studies from several states show that mandatory comprehensive coverage for infertility treatment increases premiums and administrative costs only nominally. Infertility care has the wrong impression of being expensive. It can certainly be when paid out of pocket, and often prohibitive, but when spread across the group of payers, increases for the group are small.

In Massachusetts, which has had a mandate for unlimited coverage since 1987, a state-funded study found actual premium increases are just 0.12 percent per member per month. IVF has not been overused either. This is not surprising considering that IVF is a difficult treatment that few are willing to undergo unless medically indicated.

For Washingtonians struggling with infertility or faced with the prospect of infertility when diagnosed with cancer, the clock is ticking. HB 1151 is before our legislature. Now is the time for Washington state to lead the way in access to reproductive health and join the growing number of states to hold insurers accountable for covering infertility like any other disease. Its passage will transform the lives of those in the Evergreen State struggling with infertility and for those in the years to come.

dr Christopher Herndon is Associate Professor and Medical Director of the Division of Reproductive Endocrinology and Infertility at the University of Washington School of Medicine.

It’s now time for Washington State to require insurers to cover infertility treatment

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