Establishes "The Equity in Fertility Treatment Act"; relates to the definition of infertility and health insurance coverage for the treatment of infertility.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6177A
SPONSOR: Paulin TITLE OF BILL:
An act to amend the insurance law, in relation to the definition of
infertility and health insurance coverage for in-vitro fertilization
PURPOSE OR GENERAL IDEA OF BILL:
To ensure that all those wish to become parents through in-vitro ferti-
lization (IVF) may have the coverage to do so by requiring insurance
coverage for donor cycles.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 provides the title of the bill- "The Equity in Fertility
Treatment Act."
Section 2 amends section 3221 of the insurance law to expand IVF cover-
age to include donor cycles.
Section 3 amends section 4303 of the insurance law to expand IVF cover-
age to include donor cycles.
Section 4 provides the effective date.
JUSTIFICATION:
In 2019, the New York State enacted budget established a requirement for
insurance companies to cover three cycles of in-vitro fertilization
(IVF). This legislation was intended to expand coverage of family build-
ing options, like IVF coverage, to New Yorkers regardless of their sexu-
al orientation. While the 2019 legislation afforded coverage to couples
where one of the partners is using IVF with their own eggs, the law
inadvertently left out gay men, as donor cycles, a key element necessary
to obtain an egg where there is no female partner, are not covered.
Additionally, if the female partner in unable to produce eggs and
requires donor eggs, that couple's IVF cycle is not covered either.
Additionally, the original 2019 legislation intended to cover three
completed cycles of IVF where one complete cycle begins with either
hormone treatment and retrieval, depending on the needs of the parents,
and ends with transfer. However, currently, insurance companies have
interpreted a complete cycle of IVF to only be one phase of the process.
For example, insurers have interpreted retrieval as one completed cycle
and transfer as another completed cycle. As a result, some couples are
left to pay out of pocket, even when transferring embryos from a covered
cycle, or when additional cycles of IVF are needed, and others must stop
their IVF journey entirely as they cannot afford the care. Further, when
transfers are not properly covered, it serves as an incentive to trans-
ferring too many embryos in one transfer, which is risky and leads to
bad medical outcomes.
This legislation will ensure that the 2019 law is implemented as
intended by requiring coverage of donor cycles and explicitly stating
that coverage Will be provided for three full rounds of IVF, each
including a completed oocyte retrieval and the process of in-vitro
fertilization with unlimited embryo transfers from the covered
retrieval. This legislation will ensure that those who wish to become
parents through IVF, and have the insurance coverage afforded by the
2019 legislation, are able to do so.
PRIOR LEGISLATIVE HISTORY:
New bill.
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
Immediate.
