Mandated coverage for Fertility Treatment in Washington - Help us build families

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1 in every 8 couples will deal with some type of infertility at some point in their life.

I am 1 in 8.

I am the young age of 26 years old and I cannot conceive a child through natural means. I require medical intervention due to multiple different conditions. Including PCOS, endometriosis, and a few others. Ultimately, it comes down to the fact that I do not produce viable eggs without medication, and I have a high risk for miscarriage. I cannot explain to you the impact this disease has made on my life, between the heart wrenching depression, anxiety, financial stress and so much more I have difficulty feeling like my life reaches it's potential. A lot of women feel defined by their ability to have children and raise them to be successful, constructive parts of society. This is our impact on the world in so many ways, this is the only way we leave a piece of ourselves here after we have passed away.

My husband and I have done everything we are currently able, the only procedure we have yet to attempt is invitro fertilization, primarily due to the out of pocket costs being roughly $12,000-$20,000 for just one cycle of Invitro (IVF)

This 1 in 8 equates to roughly 12.5% of American’s. According to Resolve.org, Washington State has 147,772 women of reproductive age in state that experience difficulty getting pregnant or carrying a pregnancy to live birth. This doesn’t even record the statistical evidence on the amount of men in Washington that experience this was well.

There are 7.288 million people in Washington State. Assuming 12.5% of those citizens will experience infertility at some point in their lives, we are looking at approximately 911,000 people that will be impacted by infertility .

How many states require fertility coverage? 15

Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia.

What are the average costs that an infertile couple spend on infertility?

According to creatingafamily.org “On average, women with successful outcomes spent $48,424 total on fertility treatment”

I have spent roughly 30,000 over the last 6 years. We have only had 2 pregnancies, both of which ended in an early miscarriage. Our next and only step left to take is IVF (aka Invitro Fertilization). For a lot of us, this amount can equate to a year’s wages.

So let’s talk premiums and how offering infertility insurance coverage can and will impact those that are fertile on a day to day basis.

 According to Resolve.org:

Those with infertility are 2.5 times LESS LIKELY to miss time from work due to infertility. I personally can relate to this, if I had to option to jump to IVF (like my doctor recommended) I would have stopped doing other medical treatments that have been less expensive that have ultimately just been a waste of time and money for both me and my employer.

I have been doing IUI’s (inter uterine insemination), with hormone injections of Follicle Stimulating Hormones, HCG, and clomid with very close monitoring. This causes about 6 doctor visits per month. Which means roughly 12 hours of work missed per month. As apposed to going straight to IVF which has about the same amount of doctors’ visits, but I would likely not need to repeat the cycle 6-12 times to get pregnant. 86% of couples who go through IVF get pregnant within 3 cycles.

Often people believe that adding an infertility coverage benefit will increase health care costs. However, studies indicate that including comprehensive infertility coverage in a health benefit package may actually reduce costs and improve outcomes.

For example, a survey of employers, conducted by the consulting firm William M. Mercer found that 91 percent of respondents offering infertility treatment have not experienced an increase in their medical costs as a result of providing this coverage.

Often patients select treatment based on what is covered in their health benefit plan rather than what is most appropriate treatment. For example, a woman having trouble conceiving because of blocked fallopian tubes or tubal scarring may opt for tubal surgery, a covered treatment, which can cost $8,000 -$13,000 per surgery. Many patients are forced to forgo in vitro fertilization (IVF) because it is not a covered service even though it costs about the same as tubal surgery and statistically is more likely to result in a successful pregnancy.

According to William M Mercer, “The decline in use of high-cost procedures like tubal surgery would likely offset the cost to include IVF as a benefit and provide improved health outcomes.” (William M. Mercer, Infertility as a Covered Benefit, 1997).

In states with mandated infertility insurance, the rate of multiple births is lower than in states without coverage. (New England Journal of Medicine, “Insurance Coverage and Outcomes of In Vitro Fertilization,” August 2002). Couples with insurance coverage are free to make more appropriate decisions with their physicians based on medical necessity rather than financial considerations which often result in multiple births and a high rate of complications during and post-pregnancy.

Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/per month. According to The Hidden Costs of Infertility Treatment in Employee Health Benefits Plans (Blackwell, Richard E. and the William Mercer Actuarial Team, 2000), insurance premiums now indirectly provide coverage for “hidden” infertility benefits such as surgeries to remove scarring in the fallopian tubes for women or varicose vein removal for men, were calculated to be adequate to cover more effective and often less expensive treatments such as ovulation induction, intrauterine insemination and in vitro fertilization.

So I come to you today, asking you to support our right to start a family. I ask you to take away the years of pain and suffering my husband and I have experienced, and to help ensure that no other person will have to say no to the proper treatment for their infertility due to the high costs of procedures.

 



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