Insurance coverage

DC lawmaker targets fertility insurance coverage: ‘The stress of it all is astronomical’

A member of the DC Council has introduced legislation to extend insurance coverage to include diagnosis and fertility treatments.

It can be expensive to start a family in DC, where many insurance companies don’t cover fertility issues, but a bill aims to change that.

Christina Henderson, at-large member of the DC Council, presented legislation to extend coverage provided by private insurers, Medicaid and the DC Healthcare Alliance to include diagnosis and treatment of infertility.

“Infertility treatments can cost between $17,000 and $25,000,” Henderson said. “And health insurance providers are not required to cover the cost of diagnosis or treatment.”

The measure was co-presented with members Mary Cheh, Brianne Nadeau, Anita Bonds and Charles Allen, and co-sponsored by Board member Janeese Lewis George.

While Henderson expects a pushback from insurance companies, she pointed out that 19 states, including Maryland and West Virginia, have fertility insurance coverage laws.

“We’re not pioneering anything new here in terms of coverage. And so I’m pretty confident that we can make it happen,” she said.

Changes related to Medicaid coverage, Henderson said, would require approval from the Centers for Medicaid and Medicare Services. A tab on the front of the CMS web page leads to a page on efforts to advance health equitywhich Henderson said his proposal would help.

“We know, from the research of CDC and other studies that African American women and women of color actually have a higher incidence of having fertility problems, and yet they are less likely to seek treatment, with costs usually being the main reason for which one,” Henderson said.

In urban areas such as DC, people may put off starting families until later in life, and at that time age may play a role in a child’s success. eventually.

“As a woman in her 30s. I know a lot of people now who have had to turn to fertility treatments to start a family. And the costs are astronomical, the stress of it all is astronomical,” Henderson said. And if we can do something here, through legislation that can ease the burden a bit, I’m happy to do it.”

The proposal is now awaiting a hearing before the council’s health committee; if adopted before the summer, coverage could begin in January 2023.

Gathering information to prepare for the legislation, Henderson said she was surprised to learn that some families are taking second jobs to join companies that offer insurance to cover infertility issues.

“Amazon, for example, offers fertility coverage. And with Amazon, you get your health insurance from day one, even for their part-timers,” Henderson said. “Starbucks is also another company.”

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