State bill would mandate insurance coverage for infertility

Lawmakers kicked off this year’s legislative session Monday. One bill that’s up for consideration would mandate insurance coverage for a spectrum of infertility treatments.

Barbara Collura and Julie Berman were at the Capitol this week to advocate for the bill. Collura is president and CEO of Resolve: The National Infertility Association. Julie Berman leads the Minnesota Building Families Coalition and is the former board chair for Resolve.

They spoke with All Things Considered host Tom Crann about what the bill entails and why they think it’s important.

To hear the full interview, click on the audio player above. The following transcription has been edited for length and clarity.

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What treatments would be covered under this legislation?

Julie Berman: It covers infertility diagnosis and treatment, including IVF, which is in vitro fertilization. It also covers fertility preservation for people with medically induced infertility, like people with cancer when they face chemotherapy or radiation. It also covers the LGBTQ+ community. The medical definition of infertility has recently been updated and they are also included.

How many states have passed similar legislation and how does Minnesota’s proposed legislation stack up?

Barbara Collura: We have 21 states that have some sort of infertility mandate. How does this compare? Well, I want to look at it in two ways. I’m going to start with the easy one: what it covers. The Minnesota legislation is pretty much on par to what we’ve seen in other states in terms of what it covers. It adheres to our model legislation that we’ve seen get passed in other states.

Who it covers? It would cover the fully insured market. It’s also going to cover MinnesotaCare and Medical Assistance. Those are plans from the state government. That’s what the state government can control. The state government can’t control things like self-insured companies. They can’t control federal employees who live in Minnesota. They can’t control military — that’s federal.

So, insurance in our country is very complicated and, in this case in Minnesota, we see a fairly broad coverage for what the legislature can control compared to other states.

Can you give us a picture of how much infertility care or treatments can cost without insurance?

Collura: A lot of infertility is treated through medication or very minimally invasive procedures. That’s the vast majority.

But for some IVF is going to be the standard of care. In that case, you are going to be looking at an out-of-pocket cost of anywhere from $10,000 to $25,000 per IVF cycle. And then you have to have medication that can cost $5,000 to $7,000. If you wanted to do that two or three times, you can see how that’s going to quickly add up.

This was a bill last year and it didn’t make it through. Tell us why.

Berman: Well, it was originally introduced by one of our advocates, her name is Miraya Gran from Bloomington. She was very pregnant and had a very long journey getting to that place. And she was mad. She was mad that other people were not able to get to the point she was at.

She marched into her lawmaker’s office and talked to him about getting a bill written. That bill was introduced in 2022. There was a cost study by the Department of Commerce over the summer.

Last year, it was reintroduced in both the House and Senate. We had some wonderful success in the Senate. It was amended onto the [Health and Human Services] omnibus bill and unfortunately, it wasn’t accepted in committee. So, we’re back this year and just really hoping it gets passed this year.

What do you see from other states about how much this cost? Do premiums go up? Or do the various public insurance plans in those states have to foot the bill?

Collura: This bill has two components to it. One is the impact to the state budget because of the coverage for MinnesotaCare and Medical Assistance. What we see in other states that have had an insurance mandate for IVF is that the premium cost increase for those private employers is less than one percent. It’s pennies per day.

Why do you see that this legislation is necessary now and for this session?

Berman: The reason it’s necessary now is one in seven women are experiencing infertility. And that translates to 186,000 Minnesotans.

They do not have time. People who are diagnosed with cancer don’t have time to mess with insurance. They need the standard of care to freeze their eggs or sperm right away so they can start their treatments.

So, it is just imperative that we get this done. People are suffering and it’s a disease and should be covered like any other disease.