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Paying the Price for Infertility. Part 1

by Daniel on March 30th, 2012

In the past couple of years, states have increasingly adopted laws requiring insurance companies to cover such health issues as mental illness, prostate exams, and even contraception. But it’s been eight years since any state enacted legislation requiring coverage of infertility ? a disease that affects about 6 million American men and women.

“In this country, we feel funny about sexual and reproductive issues,” says Sean Tipton, a spokesman for the American Society for Reproductive Medicine (ASRM), an advocacy group based in Birmingham, Ala. “You don’t sit around the watercooler complaining about how you can’t get infertility coverage the way you might with diabetes.”

New York Is Fertile Ground for Legislation
This year, New York could become the litmus test on the future of infertility legislation. It could become the first state since 1991 to adopt infertility legislation РЅРЅ and, advocates hope, the one that breaks the barrier that has kept infertility coverage out of the healthcare reform movement for so long.

In May, the New York Assembly approved its version of a bill that would require certain health plans to cover the diagnosis and treatment of infertility, including drug therapy, artificial insemination, in vitro fertilization, and other, more advanced reproductive technologies. The Senate version of the bill is now languishing in committee, waiting for lawmakers to resolve an impasse over the state budget.

But the New York bill has provided passionate debate that reflects just how controversial the issue is and how many competing interests want a say in the outcome. Pitted against one another are couples who want to build a family, employers, pharmaceutical companies, the insurance industry and even religious groups.

Emotional Debate Divides the Nation
An estimated $2.6 billion was spent on infertility treatment in the United States in 1996, according to a 1998 study by Cambridge Health Resources called “Infertility Management: Outcomes and Reducing Costs.” That is about 0.25 percent of the total U.S. healthcare budget for that year, notes Resolve, the National Infertility Association, which is based in Massachusetts.

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