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May 13, 2024

CT bills to expand insurance coverage for fertility care unsuccessful

YEHYUN KIM / CTMIRROR.ORG Connecticut State Capitol in Hartord.
By Ally LeMaster, CT Mirror

Two bills aimed at expanding fertility access for those on Medicaid, LGBTQ+ families and would-be single parents stalled during a legislative session with little room in its budget for new expenses.

This session, the legislature’s Reproductive Rights Caucus prioritized passing legislation aimed at ensuring access for those seeking infertility treatments. But the two bills backed by the caucus failed to make it out of committee. 

House Bill 5240, legislation that would have expanded HUSKY health insurance to cover fertility treatments for those who have been medically diagnosed with “infertility” never came up for a vote in the Appropriations Committee. House Bill 5378, which would have changed the current definition of “infertility” to extend insurance coverage to people who can’t conceive on their own with a same-sex partner, did not pass out of the Insurance Committee.

This marks the second year Connecticut lawmakers were unsuccessful in their attempts to expand fertility access.  

Medicaid and fertility access

Medicaid recipients, LGBTQ+ couples and single people remain without coverage when trying to start a family. With varying rates for fertility treatment and differences in insurance plans, many of the state’s residents are forced to pay out-of-pocket.

Those individuals include young people undergoing treatment for cancer, autoimmune diseases, genetic disorders and other conditions. 

Dr. Ellie Proussaloglou, a breast cancer surgeon at Yale New Haven Hospital, delivers this news frequently, having to talk with patients about the possibility of fertility preservation — a treatment that can cost over $10,000 without coverage. She said having to tell young cancer patients their life-saving medical treatment causes infertility is one of the most heartbreaking parts of her job, especially for patients on Medicaid. 

“It really forces patients to make an impossible choice between future pregnancy, future family building or time sensitive cancer treatment,” Proussaloglou said.

In rare instances, Proussaloglou has treated patients on Medicaid who have delayed taking medications to start a family since they couldn’t afford the costs of fertility preservation.  

“Having [a] safety blanket of fertility preservation can make a huge impact on someone’s ability to cope with the fact that they have the diagnosis and everything that they have to deal with,” Dr. Thejal Srikumar, an oncology fellow at Yale New Haven Hospital, said. 

In addition to giving HUSKY recipients the relief of coverage, Srikumar believes inclusive fertility access will help eliminate disparities. 

“Medicaid covered patients are disproportionately a minority population, particularly Black and Hispanic populations,” Srikumar said. “This ends up not being just inequity in terms of economic and financial status but also a racial issue too.”  

Only New York and Illinois provide fertility access through Medicaid. 

‘Infertility’ and limits

Since 2016, Connecticut has required private insurers to cover fertility treatments for those who have been medically diagnosed with “infertility.” Requiring a diagnosis, many advocates say, is limiting — especially for single parents and LGBTQ+ couples.  

Same-sex couples, even under private insurance, do not meet the medical definition of “infertility,” leaving many prospective parents footing the out-of-pocket bill.

Shannon Hansen started getting involved with AllPaths Family Building, a nonprofit fertility advocacy center based in Massachusetts, when she realized the hurdles to motherhood were different for LGBTQ+ couples. Hansen and her wife Megan, who live in Connecticut, have been trying to start a family for the last four years.

For the first three rounds of infertility treatments, Hansen and her wife paid the cost themselves. She estimates spending over $1,650 for the first round of intrauterine insemination or IUI — a process that costs over $1,200 for sperm that can take multiple sessions. This experience led her to start advocating for LGBTQ+ couples and single parents to get the same coverage heterosexual parents receive. 

“New parents-to-be are decorating nurseries or having baby showers or spending time together being excited about expanding [their] family,” Hansen said. “A couple like Megan and I are reading up on local legislation or advocating for policy change.” 

Hansen even successfully petitioned her employers to change her own company’s insurance policies, expanding care to cover her next three treatments. Although she is currently covered, she still works on helping other people get access to fertility care. 

“There are plenty of other women out there, who are in similar situations, whether they’re lesbians or single women, and they have to pay out of pocket just because they’re not meeting an antiquated definition of infertility,” said Hansen. 

Seven states mandate insurance companies to cover some form of fertility care for LGBTQ+ couples. 

Time and fiscal constraints

The Appropriations Committee opted not to open the two-year state budget, forcing lawmakers to abandon many pieces of legislation that called for additional funding.  

Rep. Jillian Gilchrest, D-West Hartford, had planned to combine H.B. 5240 and H.B. 5378.

“Unfortunately, when the decision was made not to open the budget, we were unable to pass Medicaid coverage of fertility care,” Rep. Gilchrest wrote in a statement to The Connecticut Mirror. “Rather than move forward with an insurance expansion, we have decided to come back next year when we can work to pass equitable fertility coverage for all Connecticut residents.”

While attempts to pass legislation protecting fertility access have failed in Connecticut this year, many advocates say they’ll be back next year to raise the issue again.

“Connecticut remains far from meeting the needs of all residents who need and deserve access to fertility health care to preserve their fertility and to build much wanted families,” Fertility Access Connecticut (FACT), an advocacy network, wrote in a statement about the legislation. “FACT is grateful to the legislative champions who have been working to advance these measures, and we look forward to continuing to partner with them next session.”

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