NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2646A
SPONSOR: Simotas TITLE OF BILL: An act to amend the insurance law, in relation to
insurance coverage of in vitro fertilization and other fertility preser-
vation treatments
PURPOSE:
To require health insurance policies to provide coverage for in-vitro
fertilization
SUMMARY OF PROVISIONS:
Sections one of the bill amends section 3216 of the Ins. L. to require
that individual policies provide coverage for (1) in-vitro fertilization
used in the treatment of infertility, and (2) fertility preservation
services, regardless of length or quality of life, medical dependency,
disability, or personal characteristics.
Section two of the bill would amend section 3221 of the Ins. L. to
require that group policies provide coverage for (1) in-vitro fertiliza-
tion used in the treatment of infertility, and (2) fertility preserva-
tion services, regardless of length or quality of life, medical depend-
ency, disability, or personal characteristics.
Section three of the bill would amend Section 4303 of the Ins. L. to
require that policies issued by a medical expense indemnity corporation,
hospital service corporation, or health service corporation provide
coverage for (1) in-vitro fertilization used in the treatment of infer-
tility, and (2) fertility preservation services, regardless of length or
quality of life, medical dependency, disability, or personal character-
istics.
Section four of the bill amends subparagraph c of paragraph 6 of
subsection k of section 3221 of the insurance law to repeal discrimina-
tory age restrictions and provisions exempting in-vitro fertilization,
gamete intrafallopian tube transfers or zygote intrafallopian tube
transfers from coverage requirements for group or blanket accident and
health insurance plans.
Section five of the bill amends paragraph 3 of subsection S of section
4303 of the insurance law to apply the same requirements to benefits
provided by a medical expense indemnity corporation, hospital service
corporation, or health service corporation.
Section six of the bill provides the effective date of the bill.
EXISTING LAW:
Currently, New York requires coverage of some infertility treatments in
the commercial market place for women between the ages of 21 and 44,
However, current law does not require coverage for in-vitro fertiliza-
tion (IVF), or fertility preservation.
JUSTIFICATION:
It is estimated that one in eight individuals or couples have trouble
getting pregnant or sustaining pregnancy. While family building options
do exist for people affected by infertility, these options are often
cost-prohibitive, with 67% of individuals or couples reporting spending
at least $10,000. High costs present a major bather to medical treat-
ment; nearly half of all individuals affected by infertility lack insur-
ance coverage necessary for fertility treatment.
The rapid advancement of medical technology in the past 20 years estab-
lished in-vitro fertilization as the safest and most effective form of
fertility treatment. Compared to treatments presently covered under New
York state law, such as ovulation induction or ovulation enhancement,
in-vitro fertilization results in fewer pregnancy complications and
high-risk births. Several states, including Massachusetts, Rhode Island,
New Jersey, Maryland, Illinois, Arkansas, Hawaii, and Connecticut, have
already enacted laws requiring insurers to cover in-vitro fertilization.
These states experience lower rates of multiple births and associated
neo-natal and pediatric care costs. This legislation has the potential
to save New York millions of dollars in long-term health care costs,
since patients would no longer be forced to rely on higher risk medical
procedures.
Under current law, New York requires insurers to provide coverage for
some diagnostic and treatment procedures for infertility. However, these
requirements do not extend to in-vitro fertilization. This bill would
update the existing law to reflect advances in modern medical technolo-
gy, requiring coverage for in-vitro fertilization to expand access to
this procedure and enable patients and their physicians to choose the
best course of treatment for infertility. It would also provide a clear
definition of infertility and ensure that cancer patients whose ability
to conceive has been compromised by chemotherapy, radiation, surgery, or
other medical procedures have fair access to fertility preservation
methods. Lastly, this bill includes anti-discrimination protections for
patients eligible for in-vitro fertilization, as required by the Afford-
able Care Act.
LEGISLATIVE HISTORY:
2015-16: A10137
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act would take effect on the first day of January next succeeding
the date on which it shall have become a law and shall apply to all
policies issued, renewed, altered or modified on or after such date.
