Spring is not the only season that brings new life — this fall, a new law will help Connecticut families grow.
Following the lead of 14 other states including Massachusetts and New Jersey, the State of Connecticut on Oct. 1 began to enforce a new law requiring insurance companies to cover the cost of infertility treatments. The bill, which was signed on July 5, adds treatment costs to policy holders’ insurance plans as they renew their contracts.
The bill also provides coverage for the diagnosis and treatment of infertility, defined by Public Act No. 05-196 as “the condition of a presumably healthy individual who is unable to conceive or produce conception or sustain a successful pregnancy during a one-year period.”
But the law imposes some restrictions on the insured — coverage is limited by the type of fertilization used and the number of menstrual cycles it is used for. Ovulation induction, for example, is covered for up to four cycles in a lifetime, while intrauterine insemination is only supported for three cycles. The law is also limited to women 40 years of age and older.
Gynecology professor Hugh Taylor, who is associate chief of research at the Yale School of Medicine, supports the bill’s aim of providing greater infertility coverage.
“I believe it is a disease like any other one contracts [and] I believe these medical problems deserve at least the same attention as other medical problems,” Taylor said. “There are women in [my] office with a medical condition that they did not ask for and did not contribute to, so it’s really a shame when they can’t afford in vitro fertilization.”
Taylor also said he now hopes the law will become standard throughout the nation. Still, Taylor said the law has many loopholes — small business owners, the self-employed and religious entities are not required to provide infertility coverage to their employees.
The new fertility law is regulated by insurance departments who have legislative liaisons with state government. One such official, Kate Kiernan-Pagani, the legislative liaison for the Connecticut Insurance Company, said her company has no opinion on the new law, but she added that the enforcement date of the law can be confusing.
“One of the most commonly confused things about the fertility law is the effective date on it,” she said. “It went into effect on Oct. 1, but that does not necessarily mean the carrier will cover it beginning Oct. 1.”
She said insurance carriers must wait for coverage until their contract is renewed so the cost of the new coverage can be added, making it confusing for policy holders.
Keith Stover, a lobbyist for the interest group Connecticut Association of Health Plans, said he dealt with the financial side of the bill and worked to decrease its monetary impact.
“It is in fact an immensely expensive insurance mandate, and because of that, it’s problematic,” Stover said. “For every dollar increased in premium, people actually lose their insurance because of cost.”
Though the bill was enacted, Stover said he is still unsatisfied with the new law because of the amount of limitations for policy holders, such as the age of the woman soliciting treatment. Still, Stover said he sees the law as a “national model” for other states looking to pass similar mandates.