Should Connecticut health insurance plans cover infertility treatment? The public weighed in Tuesday on a bill that would expand fertility treatment to single people and the LGBTQ+ community, who currently can’t meet the definition of infertility.
The state employees plan was modified last September to include coverage for single people and members of the LGBTQ+ community who work for the state.
State Comptroller Sean Scanlon, who manages that plan of 250,000 lives, said “everybody in Connecticut should be able to have a child regardless of who they love, but what we know through science is that’s not possible.”
Rep. Cara Pavalock-D’Amato, R-Bristol, said she’s confused about why a heterosexual couple would have to be deemed “infertile” to get coverage but an LGBTQ+ or a single person would not have to be.
“Their fertility is not the reason they’ve not having a child,” Scanlon said. “Their sexual identity is the reason they’re not able to have the child.”
While there’s nothing in the law that prohibits a single person or an LGBTQ+ couple from getting fertility treatment, “it is very expensive,” Scanlon said. He said requiring insurance coverage for any state-regulated plan would make it easier.
He said the simple premise behind the bill is leveling the playfield.
Pavalock-D’Amato said it seemed to be giving same-sex couples and single people the ability to access coverage more quickly because a heterosexual couple would be given six months to a year to have to prove they were unable to conceive.
And when it comes to a single individual, no individual has sperm and eggs, “that’s just how it’s made,” she said. “Nobody’s born with having sperm and eggs at the same time.”
“We’re calling it science, but really that’s nature,” Pavalock-D’Amato said.
She said that’s why she’s struggling with the language because there’s “no infertility here.”
Katherine Kraschel, an expert on the intersection of reproduction, gender, bioethics and health policy, with a particular concentration on fertility care and reproductive technologies, disagreed that there’s any discrimination.
She said the bill would eliminate the current discrimination of any person without the gametes necessary to produce a child.
As far as coverage is concerned, she said it’s her understanding that insurance wouldn’t cover the cost of acquiring eggs or sperm, but would cover any analysis of those things and any treatments or labs required before treatment, which if it’s IVF would require expensive drugs to build up a lot of eggs that would then be retrieved.
It does not currently cover the preservation of any embryos, eggs, or sperm. The cost of preservation is about $1,000 per year regardless of the number.
Dr. Mark Leondres, who is a reproductive endocrinologist, said the bill will expand access to care by aligning the medical standard of care to include the LGBTQ+ and single community to the definition of infertility by the American Society of Reproductive Medicine.
“The desire to be a parent is something separate from gender identity of sexual orientation, it’s just something that’s kind of innate within our humanity,” Leondres said.
He said most of the patients from the LGBTQ+ community don’t have coverage unless they work for a major corporation, which offers insurance that covers it.
“I think it would be great if the state would be in line with what the major corporations in the United States are offering,” Leondres said. “This bill would give patients access to care so they can build a family on their own terms.”
Connecticut’s largest business lobby testified against the bill because they said it would make health insurance more expensive for small employers.
Wyatt Bosworth, associate counsel with the Connecticut Business and Industry Association, said he’s not talking about the merits of the mandate or whether this mandate deserves coverage.
He said with the shrinking small-group insurance market, these mandates go through the health benefits review process where a cost-benefit analysis is done.
“With every new mandate, there are over 60 in state law right now. We are top three in the country when it comes to that. With every new mandate there’s an increased cost to the policyholders,” Bosworth said.
