REPORT ON BILLS FAVORABLY REPORTED BY COMMITTEE
Insurance and Real Estate Committee
JFS to the Floor 3-24-2005
TITLE OF BILL:
AN ACT REQUIRING HEALTH INSURANCE COVERAGE FOR INFERTILITY TREATMENT AND PROCEDURES.
SPONSORS OF BILL:
Insurance and Real Estate Committee
REASONS FOR BILL:
This bill would require all health insurance companies in the State of Connecticut to provide coverage for medically necessary infertility diagnosis and treatment expenses.
Proposed Substitute Bill 508: LCO No. 5042 would limit the number of in-vitro fertilization, gamete intra-fallopian transfer or zygote intra-fallopian transfer procedures to two. Limit coverage to individuals who are under forty years of age, have been with their currier for at least twelve months, and limit coverage to a lifetime maximum benefit of ten thousand dollars. It would also require that coverage services be performed at facilities that conform to the standards and guidelines developed by the American College of Obstetricians and Gynecologists or the American Society for Reproductive Medicine. Proposed Substitute 508 would also limit coverage for in-vitro fertilization, gamete intra-fallopian transfer and zygote intra-fallopian transfer to those individuals who have used all reasonable, less expensive and medically appropriate treatments and who are still unable to conceive or produce conception or retain a pregnancy. The proposed substitute bill would also exclude coverage to anyone who has had a successful birth as a result of the coverage, and it would also exclude anyone who is considered to be a religious employer (Church- affiliated organization.)
RESPONSE FROM ADMINISTRATION/AGENCY:
Rep. Chris Perone, 137th District, spoke in support of SB 508. Rep. Perone stated that he had a personal experience with infertility, and that he would like the Committee to seriously consider requiring health insurance policies to provide coverage for medically necessary expenses for the diagnosis and treatment of infertility.
Rep. Melissa Olson, 46th District, appeared in support of the bill. Rep. Olson stated that, “most health insurance carriers already provide for infertility coverage through a “major medical benefit”. Rep. Olson also said that there are over 70,000 citizens living in Connecticut who are infertile, and feels that for years insurance companies have been covering treatments that are ineffective.
Rep. Mary G. Fritz, 90th District, spoke in support of the legislation. Rep. Fritz explained that infertility effects approximately eight percent of the population, and only two percent require the invitro fertilization stage of treatment. Rep. Fritz also stated that she hoped that the bill when drafted, would include provisions from HB 5206 from the 2004 Legislative Session.
Rep. Debra Lee Hovey, 112th District, encouraged the committee to support SB 508. Rep. Hovey stated in testimony that “infertility is something that is totally beyond the control of an individual”, and should be covered under health insurance plans the same way in which other diseases are currently covered.
Rep Donald Sherer, 147th District, explained to the committee that Connecticut has some of the very finest doctors and clinics to handle infertility, and “infertility is as much an illness, disease, as any other illness or disease covered by medical insurance.”
NATURE AND SOURCES OF SUPPORT:
Pamela Pepe, executive Director of Government Policy for Serono, Inc. Ms. Pepe stated that Serono Inc., is the world leader in the treatment of infertility, and that infertility affects about six million men and women in the United States. She also stated that infertility is a qualifying condition under the Americans with Disabilities Act. Ms. Pepe also stated that assisted reproductive technologies, such as hormonal therapy, intrauterine insemination and in vitro fertilization are all critically important parts of the complete continuum of infertility care, and urged the passage of the bill.
Anita Flannigan Steenson, spoke in favor of the SB 508. Ms. Steenson stated that she and her husband have had a long and difficult time trying to conceive a child. She also feels that, “to be denied insurance coverage for necessary, proven and effective medical treatment for a disease having such devastating consequences to the individual and society as a whole is incomprehensible.”
Janice Falk, President of Resolve of Greater Hartford, appeared in favor of the bill. Ms. Falk stated that for the last three years she has been President of Resolve of Greater Hartford which is an organization that provides support, education and advocacy for individuals facing infertility. Ms. Falk also stated that she has seen success rates of Assisted Reproductive Technology increase dramatically over her lifetime, and to deny successful treatment of infertility is wrong.
Anita Lipski, came before the committee in support of SB 508. Ms. Lipski stated that her daughter is infertile and explained the great amount of stress infertility can bring on ones family.
Gerald S. Lucia Jr., testified in support of the bill. Mr. Lucia explained that he and his wife are infertile and unable to have a child. He stated that his health insurance only covers $1,500.00 a year for infertility treatment, and he has maxed out the benefits and all future treatments will have to be paid out of pocket.
Margi Goode, spoke in favor of the bill. Ms. Goode stated that she was infernal and she had undergone several different surgical procedures, most of which were covered by her health insurance provider. She also testified that she and her husband had to pay roughly $4,000.00 out-of-pocket for Artificial Insemination. Ms. Goode explained that she eventually able to have a child because a company based in Massachusetts purchased the company that employed her husband. She stated that Massachusetts mandates health insurance companies to cover infertility treatment. She stated that the reason she supports the bill is so that other people who are infertile can some day enjoy what she has with her son.
Monica Grabowy, spoke in support of SB 508. Ms. Grabowy stated that she and her husband have become a licensed adoptive family through the Department of Children and Families mainly because they have depleted their personal finances due to her infertility and can no longer afford private adoption. Ms. Grabowy asked for the Committee’s support in passage of the bill.
James Kanios, appeared before the Committee in support of the bill. Mr. Kanios said that because of his State health insurance through Anthem Blue Cross Blue Shield he and his wife are able to have the coverage for infertility treatments. He stated he supports the bill so that other families in Connecticut can start a family with out having to go into to financial debt.
Julie K. Lucia, testified in support of the bill. Ms. Lucia stated that there are presently twelve other states that require the insurance industry to cover infertility procedures and that she feels strongly that Connecticut should incorporate the same policies of infertility treatments.
Julie Salz Greenstein, Director of Government Relations, Resolve came before the Committee in support of the bill. Ms. Greenstein stated that infertility is defined as the inability to conceive or retain a pregnancy during a one-year period, and that infertility is a medically recognized disease. However most insurance companies refuse to cover treatments.
Michele Mudrick, spoke in favor of the bill. Ms. Mudrick explained to the Committee that due to the extremely high price of infertility treatments, she and her husband instead decided to adopt a child. She stated that adoption is not for everyone, and that this bill would help to lower the finical burden that infertility treatments cost for individuals.
Jennifer Kanios, testified in favor of the legislation. Ms. Kanios stated that if not for her husbands state health insurance, the out of pocket expense would be in the $30,000.00 range. She explained that because of the state health insurance she and her husband are fully covered, however she favors the bill because she would like to see other couples in Connecticut be able to have access to infertility treatments.
The following submitted written testimony to the Committee in support of SB 508
Amy and Brian Smith.
Valerie D. Taxter-Grant.
Vicki L. Balwin
Cathy and Kurt Evans
Susan and Andrew Kasznay
Amanda J. Wendt
Beth Cooper, Ph.D.
NATURE AND SOURCES OF OPPOSITION:
Christine Cappiello, Director of Government Relations, Anthem Blue Cross Blue Shield, submitted written testimony in opposition to SB 508. In her testimony, Ms. Cappiello stated that Anthem opposes SB 508, because it does not provide a dollar threshold on the infertility treatments. She also stated that the legislation would require insurers to cover all medically indicated services or procedures used to treat infertility or induces pregnancy. Ms. Cappiello also explained that many of Anthem’s products already provide benefits for the diagnosis and treatment of infertility; however, they contain certain dollar maximums per member for infertility treatments.
Eric George, CBIA, submitted written testimony in opposition to SB 508. Mr. George explained that SB 508 would further drive the cost of healthcare benefits in Connecticut, jeopardizing access to health insurance for citizens in the State.
Timothy De Carlo