Delaware General Assembly Vote Tracker

SB139 – Insurance Coverage for Fertility Care Services

According to the National Infertility Association, infertility affects 1 in 8 couples and 1 in 4 cannot afford treatment. Like other diseases, infertility should be covered by insurance, because everyone deserves the right to procreate.  House Majority Leader Representative Valerie Longhurst and Senator Bryan Townsend are sponsoring a new bill, SB139, requiring insurance companies to cover fertility care services, as 15 other states, including New Jersey and Maryland, have already done.   The fertility care services would include in vitro fertilization (“IVF”) procedures for persons, who along with their partner, suffer from a disease or condition that results in the inability to procreate or to carry a pregnancy to viability.   This Act also requires that health insurance offered in this State provide coverage for fertility preservation for individuals diagnosed with cancer and other diseases, when medically necessary treatment could adversely affect their fertility.

The bill should be passed for several reasons.   First, it closes a coverage gap.   Many Delaware families diagnosed with infertility have to pay out-of-pocket for fertility care services as health insurance companies do not respect a right to procreate.  And those out-of-pocket expenses can be prohibitive.    One IVF cycle can cost between $15,000 and $25,000 and, on average, it takes 2 to 3 cycles to achieve pregnancy.   Additionally, highly inflated managed care pharmacy prices for IVF medications, where families with coverage can pay as much as 100% more for medications compared to prices charged to self-pay families, often contribute to 25-50% or more of total IVF costs, which can quickly drain lifetime caps and severely limit overall IVF care options.

Second, with no fertility coverage requirement, Delaware is facing an economic disadvantage in attracting employees and employers, given that two neighboring states in New Jersey and Maryland do require the coverage. Many reproductive age residents intentionally change employers and leave Delaware to gain more attractive fertility care benefits.

Third, this bill will reduce or end a practice in the IVF process that often leads to multiple births (i.e. twins, triplets, etc), which, in turn, leads to higher costs all around.   When people self-pay for IVF procedures, or have limited benefits, they often demand that two or more embryos be transferred to their uterus to increase the chance of success in that one cycle.  And the reason for that is simple: as stated above, one cycle of treatment can cost between 15k and 25k.   These people may not be able to afford another cycle, so they load up the embryos to be implanted.   And more often than not, twins result.  I have two friends who had that exact situation happen to them, and this is not to say that extra twin is or was not wanted. But everyone knows that twins are just more work and more expensive, not just for the couple, but for the hospitals and for all of us.

Don’t believe me?  Well, several recent studies have found that the cost of perinatal and neonatal care for twins is about $100,000, whereas singleton pregnancies cost about $13,000. Triplet pregnancies can cost $400,000 or more. For every 100 pregnancies from IVF that are singletons (but could have been twins), about $8.7 million dollars is saved, on top of reduced pain and suffering for parents and premature babies.

Fourth and finally, this Act could increase the number of persons treated for infertility, but also increase the number of babies born in Delaware by 2-300 per year, thus increasing the state’s birth rate by 1-2% and providing a boost to the local economy, while also decreasing health care costs.

I am kinda amazed there are no Republican sponsors of this bill.  I thought Republicans were the pro-life party?  Shouldn’t they want more babies, more life, to be born?

SPONSORS: Townsend, Longhurst, Ennis, Hansen, Henry, Poore, Baumbach, Bentz, Lynn, Mitchell, Paradee
YES VOTES: Bonini, Bushweller, Cloutier, Delcollo, Ennis, Hansen, Henry, Hocker, Lavelle, Lawson, Lopez, Marshall, McBride, McDowell, Pettyjohn, Poore, Richardson, Simpson, Sokola, Townsend, Walsh
HISTORY: Passed Senate.
STATUS: Waiting on consideration in House

Delaware politics from a liberal, progressive and Democratic perspective. Keep Delaware Blue.

11 comments on “SB139 – Insurance Coverage for Fertility Care Services

  1. “I am kinda amazed there are no Republican sponsors of this bill. I thought Republicans were the pro-life party? Shouldn’t they want more babies, more life, to be born?”

    You funny! Republicans are for forced birth, where women have no choice. This bill doesn’t punish women – it helps them – so count pro-lifers out.

    They are against birth control.
    They are against comprehensive sex ed.
    They are against covering fertility treatments.
    They are for cutting Medicaid, SNAP, Head Start, Education, etc.
    They are for abstinence education – because of its failure rate, imo
    They only fight for a father’s (and parental) rights when it contradicts the mother’s wishes
    They are against abortion while also being against everything that would help once the baby is born
    They are against birth control and maternity essential health benefits

    This is not a pro-life position. This is a punishment for having sex position. Whenever they agree or disagree with a policy, I always ask myself, “How will this punish women?” Once I answer that question, I know exactly which side the GOP will support.

  2. What generates the incredible cost of this therapy, other than the usual greed of Big Pharma of course.

  3. “because everyone deserves the right to procreate” Really? Just, because?

    If you decide to put off pregnancy until you are in your late 30’s or 40’s, that’s fine, just don’t expect me to pay for it.

    • But it’s okay when we pay for old men to get erections?

      Question: Are you okay with “paying” for the children whose mothers wanted, but couldn’t get/afford, an abortion? If no, do you support safe, legal abortions?

    • Actually xyz…plenty of people who aren’t in their late 30s or 40s struggle with infertility…including my 30 year old self. And I’ve been trying to conceive since I was 27. Did you even consider that some people are born without the body parts needed to conceive? That some people do not have usable sperm/eggs due to cancer treatment? Did you consider women who don’t have tubes because they had to be removed due to ectopic pregnancy or other problems? Etc

  4. I am against government/insurance payment for ED as well.

    What do fertility treatments have to do with abortion?

    But, in any event, I don’t “support” abortions – I don’t think any normal individual “supports” abortion.

    I am OK with that personal choice though. Like the Hillary position – safe, legal, and rare.

    I also understand there are people whose conscience is offended by the taking of human life, even in fetal form, and I respect their viewpoint.

    The hardcore Catholics against even contraception? I have a hard time understanding that.

    • It has to do with consistency. Most conservatives are for banning abortion but against programs that help children once they’re born. Most conservatives are now against birth control which is a major WTF.

      And the way insurance works is that we don’t get to pick and choose. If that were the case then people with orphan diseases would never be covered. In other parts of the world IVF (and other fertility procedures) aren’t that expensive. There’s no reason why they have to cost so much here.

      I’ve known plenty of couples dealing with fertility issues, most of them were in their early to mid thirties when they found out, and ended up having babies later in life due to the cost of multiple treatments. So, this late thirties, forties person who is having a baby likely started the procedure years ago. Many waited in between procedures to raise the necessary funds for subsequent treatments. There’s a large group that would have had a baby sooner if they could have afforded to do so.

  5. There has to be some limits in relation to medical care. My insurance does not cover things like cosmetic surgery or treatment of obesity, weight reduction, or dietary control, except for morbid obesity. Generally insurance should cover that which is necessary to maintain or restore health and function. IVF is not medically necessary for health or function. Neither is something like penile implants. I guess my point is that just because something is medically possible, does not make it medically necessary.

    There must be limits because resources are not infinite. The question that should be explored is what are those the factors that should be considered when defining the limits rather than continuing to generate Delaware’s Cosmetic Surgery Law and Delaware’s Obesity Treatment Law.

    To be clear, I am not against the fertility law specifically, what I am suggesting is that there should be some criteria and process to determine how we as a nation, state, and society define those limits. I know it’s easier to nibble at it with for each special interest, but a piecemeal approach effectively results in no overall philosophy or policy. The consequence is that anything goes, and more often, nothing goes.

    • cassandram

      Limits on what insurance covers is an interesting conversation. Especially since something like 5% of patients incur about 50% of the costs. And they are most often the very young with incredibly serious medical issues or the elderly at end of life. There’s a good deal of discussion about these costs — and for end of life, there seems to be a move towards more palliative care rather than the day to day heroics. Still. There’s a good deal of discussion to be had on the limits of coverage for expensive care.

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