It can be expensive to begin a family in D.C., where many insurance companies don’t cover fertility problems, but a bill is aimed at changing that.
At-large D.C. Council member Christina Henderson has introduced legislation to expand coverage provided through private insurers, Medicaid and the DC Healthcare Alliance to include diagnosis and treatment for infertility.
“Treatments for infertility can cost anywhere between $17,000 to $25,000,” Henderson said. “And health insurance providers are not required to cover the cost of diagnosis or treatment.”
The measure was co-introduced with members Mary Cheh, Brianne Nadeau, Anita Bonds and Charles Allen, and co-sponsored by Council member Janeese Lewis George.
While Henderson expects pushback from insurance companies, she pointed out that 19 states, including Maryland and West Virginia, have fertility insurance coverage laws.
“We are not pioneering something new here in terms of coverage. And so I feel fairly confident that we can get this done,” 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 webpage leads to a page about efforts to advance health equity, which Henderson said her proposal will help.
“We know from the research from CDC and other studies that African American women and women of color actually have higher incidence of having challenges with fertility, and yet they are less likely to seek treatment, with costs usually being the number one reason as to why,” Henderson said.
In urban areas such as D.C., people may put off beginning families until they’re later in life, and at that point, age can play a role in successfully carrying a child to term.
“As a woman in my 30s. I know now lots of people who have had to turn to fertility treatments in order to start families. 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 alleviate the burden just a little bit, I’m happy to do so.”
The proposal now is awaiting a hearing before the council’s Health Committee; if it’s passed before the summer, coverage could begin in January 2023.
Gathering information to prepare the legislation, Henderson said she was surprised to learn that some families are taking second jobs to join companies offering insurance that covers infertility issues.
“Amazon, for instance, offers fertility coverage. And with Amazon, you get your health insurance on day one, even for their part time employees,” Henderson said. “Starbucks is another company too.”
