Connecticut Changes Law on Fertility Treatment
Connecticut's new law requiring insurance companies to pay for fertility treatments is different than other states' laws in that it sets an age limit. Women over 40 will have to pay their own way if they want treatment.
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A new law in Connecticut requires health insurance companies to pay for infertility treatment. Connecticut is the 15th state to mandate some kind of infertility coverage, but it is the first state to put the age limit for the benefit at 40 years. From member station WNPR, Diane Orson reports.
DIANE ORSON reporting:
For Vickie Savaris(ph), Connecticut's new law means she may one day be a mother.
Ms. VICKIE SAVARIS: I was actually ecstatic 'cause when I first found out that Connecticut didn't have a mandate and there were so many other states that did, I mean, I was even thinking of going to get a job in New York--I mean, almost anything.
ORSON: Savaris has a condition called polycystic ovarian syndrome. Without medical intervention, she could not have a baby. Before Connecticut's infertility law passed, Savaris and her husband spent close to $10,000, her entire savings account, on unsuccessful procedures.
Ms. SAVARIS: Then our next step was in vitro, and when we heard the law in Connecticut might be passed for the in vitro, we put our plans on hold, hoping for the best.
ORSON: Savaris will start in vitro fertilization in January. The law covers two cycles; each will cost between 10 and $12,000. And her health insurance will pay for them because Savaris is 32 years old.
Anita Steensen and her husband have spent close to $100,000 and undergone more than a dozen procedures trying to start a family. Steensen lobbied for Connecticut's infertility bill and testified before the state's health insurance committee.
Ms. ANITA STEENSEN: I think I was one of the first ones to hear that there was going to be a limit of 40, and my local representatives were heartsick telling me, knowing that it would exclude me and my husband.
ORSON: Steensen turned 42 this year.
Ms. STEENSEN: I am happy that something has finally been passed in Connecticut recognizing this--infertility as a serious medical condition; that, I think, is the big victory. The age limitation--we were pretty much devastated.
ORSON: Connecticut's new law covers a range of infertility procedures and is expected to affect nearly 70,000 people. Keith Stover, a lobbyist for the Connecticut Association of Health Plans, calls it `about as expensive a mandate as the state could pass.' And he says that's why the 40-year-old age cutoff is necessary.
Mr. KEITH STOVER (Connecticut Association of Health Plans): If you have scarce resources and you want to do something on infertility, where would you allocate those resources? It made sense to sort of invest in the cohort that was under 40.
ORSON: Because, Stover points out, women under 40 are much more likely to get pregnant. Other states set age limits, but the youngest age cutoff is 45. Dr. Pasquale Patrizio, director of the Yale University Fertility Center, says Connecticut's age threshold should be higher.
Dr. PASQUALE PATRIZIO (Director, Yale University Fertility Center): It has been proven over and over again that fertility decreases with age, but that doesn't mean that it's zero after the age of 40. I feel that we are leaving out opportunity for treatment to a large group of patients that will still have a good chance of being pregnant.
ORSON: Legislators say they reached the age limit through negotiation and believe it was important to open the door for infertility coverage in Connecticut. RESOLVE, the national infertility association, agrees. Advocates say they'll try to amend the law and raise the age limit. But Anita Steensen may not have the time to wait and says the insurance industry should not determine when she closes the door on her dream of having a baby.
Ms. STEENSEN: I feel like the insurance company is basically invading my bedroom. My doctor and his trained staff should be able to decide what's appropriate for each patient.
ORSON: In an effort to reduce the costs and risks associated with multiple births, Connecticut is also the first state to limit the number of embryos transferred during infertility procedures. For NPR News, I'm Diane Orson in New Haven.
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