DC bill aims to require health insurers to cover costly fertility treatments

The D.C. Council will vote on a bill on Tuesday that would require insurance companies to cover fertility treatments.

Infertility can be emotionally difficult and tough to navigate, and it’s also incredibly costly.

At-large Council member Christina Henderson’s bill requires both private insurers, as well as Medicaid and the DC Health Alliance, to cover the diagnosis and treatment of infertility, which is found to be especially cost-prohibitive to families of color.

“I felt that it was especially important given the racial justice equity issues as it pertains to fertility, in general, that Medicaid recipients and those who are on the Alliance also had access,” Henderson told WTOP.

Henderson reintroduced the Expanding Access to Fertility Treatment Amendment Act, which navigates the tricky legislative ground of writing both private and public insurers into the requirement.

“No other jurisdiction in the country had provided 100% coverage for fertility, diagnosis and treatment. And part of the reason that hadn’t happened is … the federal government has not recognized this as a medically necessary or medically reasonable diagnosis that they should cover,” Henderson said.

It put the onus on the states to cover the cost themselves, and given that Medicaid is a 70/30 partnership between states and the federal government, it would have been impossible for D.C. to cover everyone who needed the financial aid.

Henderson said she and her team found that New York modeled legislation that influenced her bill’s language.

“They covered the diagnosis. And then they also covered ovulation therapy medications, to sort of help along the process for some people. So that’s what we put in our legislation. That would make us only the second jurisdiction to go that far,” Henderson said, regarding the legislation’s potential passage.

The bill also allows for embryo transfers to a surrogate, which is often uncovered for LGBTQ+ couples, as well as coverage for fertility preservation — the freezing of eggs and sperm — and up to three egg retrievals.

“Right now, if a Medicaid patient were to have breast cancer and have to go through this process, they would have to cover the process of freezing their eggs 100% out of pocket because it’s not covered by the insurance. And we feel like that’s one area, where perhaps we could push the needle,” Henderson said.

Should the bill pass, the District will join Maryland and 11 other states, where fertility health is protected by law.

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Megan Cloherty

WTOP Investigative Reporter Megan Cloherty primarily covers breaking news, crime and courts.

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