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05/04/2007
Also please ask your rep to play "Freebird"
Ladies and gentlemen, it's time to give it up for HR 735!
(Now is when you applaud wildly, shout "Whooooo!" and make those rock 'n' roll devil horns with your hands. I think those are simply adorable.)
Known as the Family Building Act of 2005, HR 735 calls for all group insurance plans to offer coverage for infertility diagnosis and treatment. The bill, initially introduced by Rep. Anthony Weiner (D-NY) and currently being revised and resubmitted for the new Congress, stipulates that if a plan covers obstetrical benefits, it must also provide "coverage for treatment of infertility deemed appropriate by a participant or beneficiary and the treating physician." That's right: if they pay to see you through pregnancy, they also have to help you get that far.
(Now is when you thrash your head back and forth, lost to the pounding rhythm, body and mind enslaved by the insistent thrum of a relentless bass line. While you are still disoriented, please also purchase a souvenir T-shirt.)
Some highlights:
- The bill acknowledges in its opening lines that infertility affects approximately 10% of the reproductive-aged population; that the majority of insurance plans do not provide coverage for infertility treatment; and that "a fundamental part of the human experience is fulfilling the desire to reproduce."
- The bill defines infertility as "a disease or condition that results in the abnormal function of the reproductive system," and encompasses not only those of us who can't conceive within a year, but those who can't carry a pregnancy to term.
- The bill calls for coverage of up to four IVF retrievals, or, "if a live birth follows a completed oocyte retrieval, then at least 2 more completed oocyte retrievals shall be covered, with a lifetime cap of six retrievals."
- The bill's definition of ART includes IVF, GIFT, ZIFT, embryo cryopreservation, egg or embryo donation, and surrogate birth.
(I think the time is right to hump the mic stand in a most theatrical fashion.)
Now, although infertile people share a particular life experience, we're not politically homogeneous. Not all of us approve of universal insurance coverage for treatment. That disagreement often stems from concerns about the rising cost of health care, particularly as it affects small businesses. I'm not a serious student of the issue, so I can't speak with any authority, but a quick bit of research seems to indicate that the additional cost for this supplemental coverage would fall somewhere between $1 and $3 per member per month. (RESOLVE suggests that coverage might actually reduce costs.) I can understand, I suppose, why someone might not be eager to pay more every month to give someone else the chance to have a child. I do understand; I just don't feel the same way. Babies — or at least access to the most appropriate, most effective high-tech treatment — for all my friends!
(Now is when you either rush the stage, throw me into the first six rows of seats, and stomp the shit out of me in a frenzy of collective outrage, or lovingly wing your underpants — thong, boxer, or granny — at me.)
If you feel the same way and want to help the upcoming revision of HR 735 become law, here's what you need to do:
- Familiarize yourself with what the bill proposes so that you can speak or write persuasively in support of it.
- Contact your representative and ask that he or she co-sponsor the Family Building Act of 2007. E-mail is good, a phone call is better, and a real letter — paper! ink! correct postage! real human spit on the envelope flap! — is best of all. (RESOLVE has a form letter you can send to your rep via e-mail; if you want to compose your own message, you can do so through his or her official site. You can also find your rep's phone number and mailing address via the House's Web site.)
- Follow up. A poster on IVFC who's active in infertility advocacy says, "It takes a lot of nagging to get anything done. You're all going to have to call and ask for the legislative aide covering health care policy in your congressperson's office a couple of times before they will even remember to look at it." If you send a letter, she says, "Follow up after you send the original letter. I have spoken with legislative aides in congressional offices and they all say the same thing: because they get tons of letters asking for help, support, et cetera, it is difficult to give each one the attention they deserve, but when they get follow up phone calls, they are more likely to believe that it is important to the sender, rather than some form letter that they can ignore. So please follow up with a phone call, ask to speak to the person handling insurance or health care issues, and tell them that this legislation is very important to you. Tell them you would like a call back when they agree to co-sponsor it. And if you don't hear from them in two weeks, call again."
(That was the drum solo. I say it rocked, and I'll brook no dissent.)
What will you say to your representative? It's up to you, of course. One poster at IVFC wrote this to hers:
I just came across the birth announcement for your beautiful baby girl online and wanted to write a note of congratulations. Seeing your face, and that of your wife, reflected in your child must be miraculous. Sadly, my husband and I may never know that joy because our insurance will not cover infertility treatment and the cost of self-financed care is high. Sir, I pray that the birth of your child will help you appreciate all the more what couples like us have lost and are losing and that you keep us in mind when the The Family Building Act is reintroduced in Congress. Couples like us, indeed all insured people, should have access to the medical treatments that can bring life into their lives and light into their hearts. May we all experience the the same joy, love and peace that you and your wife now know.
..."Ridiculously sappy," she added pragmatically, "but sure to appeal to a big flaming Republican" like her rep.
Oh, and it also wouldn't hurt to lift your shirt. I hear the bassist really gets off on that.
Posted by Julie at 11:29 AM in Hellbound handbasket | Permalink
Comments (77)
AAAAAweSOME!!! Of course, I already have kick ass coverage, better than stipulated in the bill, and if it passes, the quality of our insurance may actually decline to fit the standard. AAaawww poop! It won't stop me from trying to get the bill passed. Unfortunately, I live in Connecticut, insurance capital of the world, and getting insurance companies to do anything is a huge stretch. It was a huge deal when we got insurance to cover birth control. The insurance lobby is VERY strong here, and they give a lot of money away. (it was an insurance company that backed the scholarship that made it possible for me to pay for college) (I doubt if any CT congressman/woman would have the stones to vote for this bill)
Posted by: Chickenpig at May 4, 2007 11:43:16 AM
I would not have my 3 month old son today if my insurance did not fully cover fertility and reproductive treatment. I could never have afforded all the specialists and surgery and my wonderful RE who finally helped us carry a pregnancy to term. After 4 miscarriages and 3 different groups of OB's no one could figure out how to help me. If my insurance had not covered my RE we would not have gotten that far, and eventually been successful. It is so sad that everytime I went in his office, there was a note up with another ins. company that would not cover services there. I am a NICU nurse, and I take care of a lot of patients that my tax dollars help provide medical benefits for, 3 bucks is not much more of a burden to help another couple experience the joy of having a child.
Posted by: Nicole at May 4, 2007 11:45:15 AM
Thanks for sharing that, I'm going to pass it on to everyone I know.
My hubby and I can't afford IVF, which would be our best option for pregnancy, and living on a part time job, and a military income sure doesn't come up with 10-20k really quickly. This bill would be a wonderful, wonderful thing. Thanks for sharing!!
Posted by: Samantha at May 4, 2007 11:49:36 AM
I think the costs you mentioned are very reasonable when you consider how much we've all been paying for the health issues that accompany smoking for years.
Posted by: susan at May 4, 2007 11:59:39 AM
I'm totally in support of insurance companies covering infertility treatment. Completely support it. (If only everyone had insurance, ah to dream.)
However, I have to wonder if a bill like this will have the opposite effect in that more insurance companies will stop covering regular prenatal care. As someone who didn't have prenatal coverage with a pregnancy that resulted in an emergency c-section to the tune of $9,153.40 (I had nightmares over that dollar amount) which was the hospital bill only, and did not include my obstetrician bill, pediatrician, anesthesia, etc, I would hate to see less people have maternity coverage because the insurance companies didn't want to cover infertility.
Also, would Medicaid cover this? I know Medicaid pays for maternity coverage (if you qualify - I did not). I'm not sure how I feel about Medicaid covering infertility. I'd hate to deny anyone children who want them, but if you can't afford insurance maybe you can't afford a baby? I don't know, I haven't thought it through enough to get a rational POV on the Medicaid issue, but I'd be interested to know if Medicaid would be required to follow the law of this particular bill.
Anyway, I applaud the effort either way and I hope I'm wrong about the effect the bill if it should pass.
Posted by: Amy at May 4, 2007 12:14:02 PM
Samantha, good news — there's also a bill afoot (HR 1418) to provide coverage for military personnel and their families. RESOLVE's letter asks for support for that one as well.
Posted by: Julie at May 4, 2007 12:14:29 PM
I don't begrudge anyone the luxury of having infertility costs paid for by insurance. This is good news for all infertile couples, myself included. However, speaking objectively, what I worry about is that more and more plans will discontinue covering maternity costs *at all* because of the high cost of treating infertility, which only affects 10% of couples. Someone ends up paying for it, whether it's employers who provide coverage, covering less and less and forcing the employees to pay more, or whether it's people paying for their own health insurance. As a result, the 90% of couples who *are* able to conceive without fertility treatment will have less and less coverage for pregnancy, and so will the higher-risk infertile couples. This may not be such great news, in the end. Unfortunately, this leads me to believe that this is just one step closer to socialized medicine, which would ultimately crush America's healthcare system even more than it's being crushed by all the regulations imposed by the government today. Ask someone from Netherlands how many weeks they have to wait to see a doctor for a simple urinary tract infection. Last time I heard the wait to see the regional doctor(s) for something like that was two (2) weeks.
One day there may be no coverage for infertility OR maternity at all, because there is no way that the government will be able to afford to cover it for everyone who is infertile, on top of couples who ARE fertile. It's way too expensive.
Just my humble opinion... I don't want to start a war of words or anything. My fear is that these short-terms gains may end up causing long-term setbacks.
Posted by: Undisclosed for fear of retaliation ... at May 4, 2007 12:18:44 PM
Thanks Julie, I will be sure to check that out right away.
Posted by: Samantha at May 4, 2007 12:19:41 PM
Wow.
I live in Massachusetts. I had thought I had it made, since we have the same deal here, if they pay for pregnancy they have to pay to get you that way. Then I found out that if you company was self insured (as most companies or any size are), there was this huge federal loophole saying that they didn't need to comply with local state laws. Oops. I started paying for insurance out of pocket and even changed jobs because of this.
This law might help, even for us lucky folks in Massachusetts. If its a federal law, then I'm betting even self insured companies have to comply. Here's hoping.
Posted by: Elizabeth at May 4, 2007 12:26:41 PM
Dear Undisclosed,
I didn't read the comments until after I had posted mine...
As I said, in Massachusetts the same basic thing is already the law of the land (unless you fall into the loophole). There is not a vast movement of plans to not cover maternity in order to get out of covering infertility. I think the insurance companies figure its not worth the inevitable outcry from all the fertile people out there just to get out of covering a few IVFs.
As to who should pay... well that's a more complicated question than you set it out as.
Currently most people pay for health insurance with pre-tax dollars, through their employers at a rather large discount. I, on the other hand, opted out of my employer's insurance so that my previous IVF and my next one would be covered under state law. Now I am paying with post-tax dollars at no discount. I can't use pre-tax dollars because I am eligible for insurance through my employer, but of course if I take that insurance it won't cover the only darn thing I need the stupid insurance for. (Yes, I'm bitter about this, thanks for asking.)
Basically we are in the situation that the government is subsidizing some types of health care and not others. This is the part that to me is unfair. I take good care of myself, and it seems grossly unfair to me that the government will mandate coverage of preventable stuff when it won't help me out with the endometriosis that I could not prevent. Actually, I'd be happy if we all had to pay for health insurance on our own dime (assuming it was the same dime, either pre-tax or post-tax), and we picked the plans that worked for us. Right now I'm paying for something on a post-tax dime where most people can use a pre-tax dime because their problems are covered, and that makes me cranky.
Posted by: Elizabeth at May 4, 2007 1:09:49 PM
*nods*
Try being an infertile lesbian.
Not only does my healthcare NOT cover infertility treatment, my partners DOES. becuase MY employer is CATHOLIC... so they don't cover because of MORAL reasons. However, she has physical problems that will not allow her to get pregnant. Period. It's not infertility in her case. So, I will need to carry the child.
Nope. No coverage. But HER plan would cover it!
Oh, be wait! We can't get married or even have a civil union here in Ohio! After issue one passed, many places even dropped the domestic partner benefits that they were offering. Soooo... we are denied the basic rights that other tax paying citizens are afforded, simply becasue of who we are, on top of dealing with the expense of trying to have a child.
And to top it off, It's not just a matter of IVF because I "don't want a man".. I tried for 2 years when I was "straight"... no go.
The government dictates a lot of things that are not fair based on random "ideas" and outdated "morality". I will pass this on to to everyone I know. Babies for all!
Posted by: Lurker at May 4, 2007 1:24:29 PM
I think this is a good bill, but unfortunately it still only covers those of us who have insurance. Many, many Americans do not have even the most basic insurance. And, to the poster who gave the example about the 2 week wait (no, not that "2ww") to see a doctor in Holland, I don't know what insurance you have, but with Kaiser, I OFTEN have to schedule appointments several weeks or months out...can't see how this is much of a difference from countries with socialized medicine...
I doubt insurance companies will stop paying for prenatal care, though, because they are coming to realize that it's much MUCH cheaper for them to cover monthly obstetrical visits than having to pay for follow up care for a sick infant (I don't know how much a 1 day stay in the NICU costs, but I'm betting it's more than all 9 months of prenatal costs combined).
I have an idea, though: maybe the insurance companies could start recouping the extra $ they would pay out for AI by cutting coverage of Viagra???????
Just a thought. :-)
Posted by: Anne at May 4, 2007 1:40:58 PM
Sorry...AI and other kinds of infertility treatments, of course!
Posted by: Anne at May 4, 2007 1:48:23 PM
I hope it passes somehow. What I'd really like to see is enough coverage that the stakes per try aren't so high, thereby decreasing the incentive to take riskier approaches (such as multiple embryo transfers in good IVF candidates). I'd even be OK with some regulation in exchange for decent IF coverage in an effort to reduce the numbers of preterm and multiple (especially HOM) births in this country. The concequences of not having universal IF coverage aren't limited to people not getting to conceive and carry children. It's a start, though. Thanks for letting us know.
Posted by: Emmie (Better Make It A Double) at May 4, 2007 1:57:19 PM
Yes, this is absolutely true. I just found out within this week that my insurance (Blue Cross Classic HMO) is now covering all infertility (including procedure & hospitalization) 50%.
In addition, I talked to a Blue Cross rep the other day and he confirmed all of this, because of course I couldn't believe anything I read in writing. He also said Blue Cross covers a lifetime maximum of $1500 on injectibles and then after that, it's like 30-75% based on various things... I kind of spaced out after I heard the bit about 50% on everything. I am so freakin' excited.
We've been trying to go the slow, natural, CHEAP route for the last year because we couldn't afford IVF w/ICSI on our own.
Now we can go full steam ahead and paying half will be much easier to swallow. Although I wonder how this works on the 'buy 2 or 3 upfront' deal. Insurance obviously won't kick their portion in until necessary, so that's kind of fuzzy.
Finally, some relief and hope in sight for all of us struggling with infertility!
Posted by: Liz at May 4, 2007 1:58:39 PM
Thanks for sharing this, Julie. As a totally broke IVF veteran, this bill has my wholehearted support. I'm holding up my lighter and yelling "freebird" down here in TX, where we sure could use some legislation forcing insurers to cover infertility treatment.
Posted by: kristylynne at May 4, 2007 1:59:01 PM
Holding my lighter's flame high.
Except is is about a #$^*%^@#% decade too late for this bitter old woman.
Posted by: Cricket at May 4, 2007 2:26:33 PM
I know it's terrible, but the pessimist in me worries that insurance companies will say, "fine, then we're paying for obstetrical care" in order to avoid having to cover fertility treatments.
Posted by: Karen C. at May 4, 2007 2:45:45 PM
As an insurance person, I had to step in. Please, everyone, remember that any federal regulation only applies to self-funded medical plans (where the company hires a claims administrator and network for the discounts, but actually pays all the claims). If you have a fully-funded plan, that falls under state law, not federal - and they have NO OBLIGATION to pay for anything that the federal government mandates.
(And, confidential to the lady that works for the Catholics: I work for the Lutherans and it's the same thing. Not only that, but they don't offer adoption assistance...even though there is a HUGE Lutheran adoption agency. Apparently, if you can't have them the "normal" way or if you want to offer a disadvantaged child a home, you are just s*** out of luck. Restriction of health care because of "moral" concerns (again, totally legitimate under most self-funded plans) are perfectly valid...which is why we need to get away from the model of employer-provided healthcare.)
Posted by: Diana at May 4, 2007 2:55:36 PM
Just wanted to add something to the "Do these things to help" list. If it's not too painful, come out as infertile. Tell your neighbors, co-workers etc. about your experience and the legislation. You'd be surprised how many folks *never* think about it. And when it comes time to vote on a bill that will, no matter how you cut it, initially cost insurance companies money, the more people who support it, the better.
Posted by: erin at May 4, 2007 3:01:48 PM
Ahh, a bill! (Why is school house rock playing in my head?)
My fingers, toes, and eyes are crossed for this and I will most definitely be on the phone with my rep - We'll be on a first name basis before long.
My former job covered 50% of infertility treatments. Hubby is self-employed, so we were counting no my coverage to help us though. We had saved up a handsome little fund to aid in our assisted reproduction adventure, figuring after a month or two we would be pregnant and have the rest to spend on baby. We breezed through all of it in less than a year, and that was paying only HALF of the total costs. I was laid off from that job last year and found a new job, which is fantastic and I took a definite pay raise, but alas... no if coverage at all. We can afford clomid and the occasional IUI but so far that hasn't done squat. No m/c here... just no pregnancies at all in 5 years.
IVF is simply not an option for us because of the cost, and by the time we saved up enough for a couple of rounds I would be one of those women you hear about on the news, giving birth to quads at age 62. The way the halthcare system is now, if you're not fertile or wealthy (or willing to go so far into debt that your IVF baby's babies will be paying your RE) you can kiss your baby dreams good-bye.
So, HR 735, you have my support. Rock on.
Posted by: Cassandra at May 4, 2007 3:23:51 PM
I probably shouldn't interfere in this debate, but I couldn't resist the comments about "socialized medicine" and the Netherlands. In Scandinavia, we have a public health system. My GP has an appointment or two every day which is kept open for acute cases such as UTIs. My prenatal care, delivery and postnatal stay in hospital (three nights) ended up costing us $1 (the cost of the first urine sample glass), everything else was free. And the best part is that this care, which was all excellent, is available to everyone. Of course, you may not be willing to accept the level of taxes we pay (roughly 28 % on normal income), but the system itself is surprisingly well-functioning.
Posted by: vilde at May 4, 2007 3:47:34 PM
This is just a bit off topic, but I've never once heard of someone from a nation with a socialized health system complain about either the tax rate or the quality of care. Everyone I have ever spoken with is satisfied with the system for the most part.
Posted by: Unknown at May 4, 2007 4:08:12 PM
To add to that and to comment on the previous poster's remark about 28% tax rate... I pay a nearly $500 premium per month for health coverage that is provided by my employer. This is on top of the 20-25% of my paycheck that goes to tax.
Bring on the socialized health care.
Posted by: Unknown at May 4, 2007 4:23:23 PM
Part of the wording of this bill strikes me as odd - the definition of infertility as "a disease or condition that results in the abnormal function of the reproductive system". I didn't read the whole bill, but is there an age cut off? Because after a certain age, difficultly conceiving is not abnormal at all. So if I were an insurance company trying to avoid paying for infertility treatment, I would simply argue that this bill does not apply to women over (whatever age, 35? 40?) because at that point difficulty conceiving is not "abnormal".
Posted by: Michelle at May 4, 2007 5:03:57 PM
Gosh, it would have been nice to have any coverage at all when we were pouring thousands into ART... but just $400 short of being able to take the medical deduction on taxes. I have a feeling we'll be screwed out on the other side as well when adoption credits get cut off. But at least somebody is trying to improve the situation... Thanks, Julie, for bringing this to our attention.
Posted by: Marie at May 4, 2007 5:35:35 PM
The US government spends more than half of the DEA budget - upwards of 50 million tax dollars every year - trying to keep people from smoking marijuana.
I think we can all agree that pot smokers are less of a societal problem than our disastrous health care system. Bring it on!
Posted by: Matthew M. F. Miller at May 4, 2007 5:39:12 PM
"a disease or condition that results in the abnormal function of the reproductive system"
Betcha I know what that's there for -- to deny the icky lesbians coverage for ART. Gee, considering how many of MY dollars go towards insurance coverage of birth control for straight couples, you'd think that the straight couples could spot us a little sperm...
Posted by: Nina at May 4, 2007 6:59:42 PM
I have to wonder if the $1-$3/month additional cost is a correct number. When I had IVF, I bought into a group policy in a neighboring state. The monthly premiums were a $400 increase/month for Libery instead of Freedom (read: less drs. & hospitals covered). I think to be fair, Resolve should factor in that with IVF coverage there are more multiple births, NICU costs, etc. I figure that my infertility treatments, twin pregnancy, hospital bed rest, and NICU stay in all totaled about $500,000.
I do believe that places like England limit IVF transfers to 2-3 embryos because of the exorbitant expense of multiple pregnancies and their births.
Posted by: thrice at May 4, 2007 7:46:34 PM
This would be fantastic. I have yet to see one of my employers in California carry infertility treatment coverage. It would be a dream to have this coverage as I am on the verge of needing this coverage.
Posted by: Teenuh at May 4, 2007 8:10:06 PM
Cool. And I live in NY. I'll poke everyone I can.
Posted by: maggie at May 4, 2007 8:14:17 PM
I live in South Carolina and my IVF was covered by my State Blue Cross/Blue Shield insurance. Thank God. It makes up for the 8 years of that same insurance plan not covering pap smears or birth control.
More seriously, I've always assummed that the fact that South Carolina had this supportive and progressive legislation, was because it was a counter balance to the legislative roadblocks that South Carolina puts up to oppose abortion.
I'm not happy about my state's general opposition to general health and choice issues, but the flip side may well be progressive legislation for fertility issues.
I've got no evidence...just my hunch.
Posted by: susanna at May 4, 2007 8:23:41 PM
I work for the state of Illinois. I have Health Alliance HMO, which covers IVF, AI, GIFT, ZIFT, donor sperm & eggs. 4 retrievals per lifetime are covered unless you have a live birth, then you get 2 more retrievals. Fertility drugs are covered by the pharmacy benefit. Each pregnancy is subject to a $50 copay for prenatal care, unless you also need a specialist. Then you also have to pay $15 per visit for each specialist visit. But oddly enough, even though state law requires coverage for birth control, the only birth control covered is a few brands of the pill or sterilization. No depo, no patches, no diaphram, no IUD, so if the pill isn't suitable, no coverage. And I'm pretty sure over 50% of my gross income goes to taxes of some sort - income, social security, property, sales tax, motor fuel tax, license fees etc. Plus I still pay about $200 per month in insurance premiums for my dependents (which is a bargain I know)
Posted by: jennifer at May 4, 2007 8:45:52 PM
It's nice to see this legislation wouldn't contain that other loophole that plagues Massachusetts - infertility coverage only for people who can't conceive, a pregnancy, not those who can conceive but not sustain. In other words, too effing bad recurrent miscarriers!
Posted by: Karen at May 4, 2007 9:12:17 PM
I disagree with Undisclosed. I think the state and/or insurance companies *can* provide a top-notch healthcare system with universal coverage.
People have this mindset that there's not enough health cover to go around, and it needs to be rationed out. But if you run your system correctly (not all socialised systems do) you'll be able to make enough healthcare for everyone. It's not a finite resource.
(And yes, a number of studies show it's cheaper to fund IVF up front than pay for complications arising from higher rates of multiples.)
Bea
Posted by: Bea at May 4, 2007 9:55:47 PM
It's about time! I live in Chicago and I know how supremely fortunate I am that Illinois passed that law in 2004. It's so good to live in a blue state! See link for info. http://www.idfpr.com/DOI/HealthInsurance/infertility.asp
Being teachers, my husband and I would have had to beg, borrow, and steal to get the treatment we so desperately need. Thank you for passing this on so we can all work to get this bill passed.
Three cheers for the Dems. in 08'
Posted by: Wendy at May 4, 2007 10:10:13 PM
Big pair of granny panties flying your way!
I met Richard Weiner last year in D.C. when I went with RESOLVE to lobby for this exact bill. It's good to know that it's been drafted. I fully intend to bug the living crap out of my reps until the thing passes. It's the least I can do for all of us.
Posted by: Flicka at May 4, 2007 11:36:21 PM
Go, Weiner! And Julie, for letting us know about this (holding up lighter...).
To comment on the comments --
Nina, I doubt if the phrasing of the bill, "a disease or condition that results in the abnormal function of the reproductive system" was intended as a blow against lesbians (or gays), though I agree it might mean this bill doesn't extend coverage to that group (or to any people not ttc through heterosexual intercourse, for that matter). Rather I would guess that as Karen notes, it probably was worded that way to avoid the problem with the MA law that has been interpreted to apply to those who cannot get PG but not to those who cannot achieve a PG that leads to a live birth (i.e. recurrent miscarriers don't get treatment).
And to those worried about funded infertility treatments driving up insurance costs, there is, as several others have noted, a plausible argument that by reducing the temptation to transfer a ton of embryos -- and by making IVF more accessible (so that decent responders could use it, rather than IUI where the number of embryos that reach the uterus cannot be as precisely controlled) -- infertility coverage can reduce, rather than increase, total costs. This was discussed at great length earlier on this very blog, though I forget exactly when.
Posted by: Alex at May 5, 2007 12:32:23 PM
I share the concern that many insurance carriers will simply drop prenatal care rather than pick up the bill for infertility treatment.
My insurance company does not currently cover prenatal or delivery costs. That was a big part of the reason I opted for a $2000 home birth rather than a $10,000+ hospital birth.
Posted by: anon in New England at May 5, 2007 1:43:46 PM
holding lighter aloft.
Thanks for the info!
Posted by: Lisa Gilbert at May 5, 2007 4:33:39 PM
also, as a former senate intern...
handwritten letters (neatly) get more attention because they catch your eye.
Posted by: Sassy Belle at May 6, 2007 1:24:05 AM
Just because a country has socialized health care does NOT mean we have infertility coverage!!
In Canada, we do have a health care program, but it is different in each province.
Here in the province of Alberta, all taxpayers pay a monthly premium to the Alberta goverment. This is for standard health care ONLY.
Canada has ZERO infertility coverage!!!!!!
The ONLY province in Canada that has any type of coverage at all is Ontario, and THEY only cover an IUI -- IF , and ONLY IF -- your need for an IUI is caused by a blocked tube!!!
In the blog world and on IVFC I talk to a lot of women from all over the world.
And it is frightening to discover that 99% of the general population in other countries AUTOMATICALLY ASSUMES that Canada has 100% infertility coverage JUST because we happen to have a socialized health care system!!
Wrong. I FREAKING WISH we had even a scrap of IF coverage in Canada!
My husband's company and a company I used to work happen to have FANTASTIC prescription drug coverage though -- so the only thing we haven't had to pay for is our meds. But other than that, we are 100% SELF PAY, and we are thousands of dollars in debt because of it, with NO LIVE BABY to show for it!
I would BUY insurance that covered IF treatment if I could -- we would happily pay higher premiums through my husband's work insurance coverage, but there is no insurance coverage for IVF available ANYWHERE in Canada. (at least not to my knowledge.)
We have good maternity benefits here -- one year off at 55% of your salary (up to a maximum cap) -- but that doesn't really do me much good since all of my babies are dead....
Posted by: 'Nilla @ Vanilladreams at May 6, 2007 5:50:41 AM
But at least I'm not bitter.....HA! :/
Posted by: 'Nilla @ Vanilladreams at May 6, 2007 5:52:51 AM
Hi again, ive found this blog post interesting.
Here in New Zealand we dont have to have insurance to access medical care. At present we are goverment funded for two cycles of ivf. This includes all the luverly drugs im starting to cringe about as well as frozen embryo transfer. From the day we book on we have 18 months to complete transfer of all embryos. If we still have any frozen embryos left we have the choice of paying to have them, donating them for reasearch or destroying them. This is of course, if you have any embryos worth freezing and any that survive freezing.
If we don't get pregnant during our first cycle and our 18th months are completed, we then book on for our second cycle of ivf.
If we still arent pregnant then we have the choice of giving up, taking out a whopping loan or considering adoption and the majority of adoptions in new zealand are open adoptions where the birth mother has open access to the child.
I really hope this bill gets passed through for all infertile couples and this post has made me feel thankful for what we do get free here in new zealand.
Julie i have been reading your blog for a while, and being able to read another persons experience of ivf, has made it a little easier for me as i know a little more of what to expect. Personal experience is far more informative than any medical pamphlet or book. I cant thank you enough for writing this blog!
My husband and i will be booking on for our first cycle of ivf in july and im excited and scared shitless at the same time.
Posted by: Larissa at May 6, 2007 6:43:53 AM
isn't it nice to be blogging about a bill to support for a change?
Posted by: Naomi at May 6, 2007 7:06:52 AM
To clarify, the infertility treatments I was referring to do not fall under the category of "regular healthcare". I don't see how they possibly could be considered normal care. When there is such a huge minority of people who have these issues, one can't begin to think about being *entitled* to this category of healthcare. Yes, it would be wonderful if there was some magical system where everyone could have everything they ever wanted and only pay $1 for it. I am all for that, when we are living within that magical system. Until then, the money has to come from somewhere. It's only common sense. I never said that there was only a certain amount of healthcare to go around. I just said that someone, somewhere, has to pay for it. Maybe not everyone is entitled to infertility treatments. I have worked hard my entire life, and I have gone through a lot with infertility, and I have paid for most of my "healthcare" by myself. I don't think that it's someone else's responsiblity to pay for something that is purely my responsibility. Having children is something that I very much want, but I don't want it at the expense of anyone else. That's just my humble opinion. Everyone is entitled to at least that.
Posted by: Undisclosed at May 6, 2007 7:52:22 PM
Thought #1: I guess I don't get the worries that if IF treatment is covered, the ins. companies will deny maternity care. The two are not on equal footing to me and are different issues. Is it because the bill states that if the insurer covers maternity, they must cover IF, therefore the opposite will be true? I can't agree with that scare.
Thought #2: The one thing that I worry about is that if insurers start to cover IF, they will get more involved with the actual care, specifically the # of embryos transferred. That was already talked about last year, with the recommendation by ASRM to limit the # transferred. If the insurance companies are "forced" to cover IF treatment, then you can be damn sure they will want to limit the HOM births by lobbying the gov't to regulate the # of OUR embryos we put back in to OUR bodies.
Thought #3: A bit OT, but I hate companies that cover abortion but not IF treatments....
Posted by: Mcass at May 6, 2007 8:57:30 PM
If this passes, I wonder - what about the other side of the fertility spectrum? Will it be easier to get birth control pills/shots/patches and the like? Because preventing pregnancy is cheaper than going through it...
-dodges bullets-
(Yeah, anyone want a healthy, young, unused uterus? Free to a good home.)
Posted by: Clover at May 7, 2007 2:05:28 AM
Been fighting a long time for this one. I sure hope it passes. What hasn't been mentioned here is the fact that IF has been deemed a bona fide disease for decades by the AMA, yet, unlike almost all other diseases, insurers have been able to discriminate against infertile people. Not covering IF is like an insurance company deciding willy nilly that they won't cover, say, diabetes. It's unheard of because of the obvious unfairness of singling out certain diseases to not cover. The AIDS people were treated this way at first, but because they were very vocal and had a ton of support, AIDS is now covered and insurers can't just not cover it.
Infertile people are one of the truly stigmatized groups, and because our numbers are so few, and our disease so personal and YIKES! associated with SEX - it has been easy for insurers to go along with the masses and conclude that "having a baby is a choice" (not if you don't have a choice) or that they simply don't need to cover it because they can get away with it.
We need to speak out and be heard! Stop arguing over whether or not this will drive up costs or make insurance companies try to stop covering obstetrics. This is a fundamental matter of fairness -- insurance is there as a pool of money to spread out the high cost of health care. Infertile people -- on principle -- should not be excluded from having their needs met if they are contributing to the pool. Not having coverage for IF is an iniquity that should be corrected.
Also - you may not realize it, but the IF docs are making a bundle off IF patients because most IF is handled as if it were cosmetic surgery -- completely in cash! IF treatments are not cosmetic surgery. Beware that the docs know that their cash cow might go away if this bill passes and the bad ones won't support it.
Posted by: Mel at May 7, 2007 2:28:40 AM
Like most legislation, it's got it's good points and bad but the spirit of it is positive and I like that.
I also love the opportunity to bring this up as a discussion topic and for others to as well - others who may not have ever thought about it b/c they are fertile...it's all about awareness in the end.
Great post Julie - thank you so much for bringing this to our attention.
Posted by: A'Dell at May 7, 2007 9:24:52 AM
