Washingtonians deserve equitable access to infertility care

Infertility is a disease that affects one in eight. Unfortunately, Washington is not a state that requires health insurance plans to cover infertility care. Resulting out-of-pocket costs make it difficult, if not impossible, for most people impacted by infertility in our state to afford medically necessary care. The disparities that exist are profound.

It is likely that we all know someone who struggles with the devastating impact of infertility. Infertility has no bounds of geography, gender, race, religion or sexual orientation. Further, patients diagnosed with cancer are often at risk for medically induced infertility and only have a narrow window for fertility preservation before the start of their cancer treatments.

Without a requirement for insurance plans to cover infertility care, the ability to build a family becomes a function of economic privilege for the tens of thousands who face infertility in our state. Access to appropriate medical care is mostly reserved to those who are wealthier or happen to work for the “right” employer that offers fertility benefits.

People with less means who lack fertility coverage shoulder the entire cost of fertility services themselves, adding financial stress and debt on top of the already considerable emotional burden of infertility. Many are simply unable to afford care. Others prematurely stop treatments when their savings run out.

The status quo in our state disproportionately impacts people of color, those who are less affluent, and those who provide essential services, such as schoolteachers, whose insurance benefits do not cover infertility care. It discriminates against the LGTBQ+ community and others who require medical assistance to have children.

A new bill in the Legislature, the Washington State Building Families Act (HB 1730 and SB 5647), would require health plans to provide coverage for the diagnosis of and treatment for infertility, and to ensure coverage for fertility preservation services for cancer patients and others at risk for medically induced infertility. At its heart, this bill is a call for equity in Washington state.

Long-term data from states that have had infertility insurance mandates for decades show nominal increases in health insurance premiums of less than 1% when infertility treatments are fully covered. This does not even take into account the substantial savings from the lower rate of multiple gestation pregnancy in those states due to safer medical practices and patient choices.

Over the past four years, four states (Delaware, New Hampshire, New York and Colorado) have passed laws requiring insurance plans to provide comprehensive coverage for infertility. The most recent is Colorado, which passed legislation in 2020, during the COVID-19 pandemic. In signing the bill for his state, Gov. Jared Polis cited the impact of the COVID-19 pandemic as yet another reason infertility should be covered by insurance.

This bill before our Legislature, HB 1730 / SB 5647, is essential to mitigate the profound health disparities and lack of equity that have existed for far too long in our state. Supported widely by patient advocates, nurses, physicians and health organizations including the Washington State Medical Association, this legislation affirms the right for all who struggle with infertility to build a family.