Equal Infertility Coverage for All

Section 2 amends Section 3221, Subsection (k), Paragraph 6 of the Insur- ance Law by adding a new subparagraph (E), which provides that no group or blanket policy which provides infertility coverage may place addi- tional requirements for this coverage on an insured who has a partner of the same sex. The Subparagraph further requires that for insureds with a partner of the same sex, the insured's partner's sperm may not be required to be used in covered treatments or procedures nor that the insured demonstrate infertility exclusively by means of a history of unsuccessful heterosexual intercourse. Further, in the event that a group or blanket policy includes coverage for in vitro fertilization, such policy may not place additional requirements to trigger coverage for insureds who have a partner of the same sex.

Section 3 amends Section 4303, Subsection (s) of the Insurance Law, by adding a new paragraph (5), which provides that no contract for health coverage which provides infertility coverage may place additional requirements for this coverage on an insured who has a partner of the same sex. The Subparagraph further requires that for insureds with a partner of the same sex, the insured's partner's sperm may not be required to be used in covered treatments or procedures nor that the insured demonstrate infertility exclusively by means of a history of unsuccessful heterosexual intercourse. Further, in the event that a contract includes coverage for in vitro fertilization, such policy may not place additional requirements to trigger coverage for insureds who have a partner of the same sex.

Section 4 sets forth the effective date of the legislation.

Justification

In 2011, New York State took a historic step forward by becoming the first State to legalize gay marriage through legislative means, via the passage of the Marriage Equality Act. While this was a milestone in recognizing the concept of equality for all New York families, some of the Empire State's codified policies have yet to catch up to this significant legal recognition.

At the core of progressive tenets of marriage equality and family equal- ity, is the equal opportunity of every New York couple to access the necessary tools to adequately plan their families. However, to this day, many legally married lesbian couples in New York State may be confronted with the stark realization that in their own attempts to grow their families, their insurance providers may not provide equal fertili- ty treatments that they would be eligible for if they were in a hetero- sexual marriage. Where most insurers who cover insemination procedures, and other fertility treatments, typically maintain requirements relative to a history of unsuccessful conception following heterosexual inter- course, or require the use of sperm provided by a patient's partner, it is a physical impossibility for lesbians to meet these criteria. Espe- cially following the State's legislative determination that marriage be recognized and respected in all of its forms, it is wrong to allow New York's insurers to punish lesbian families on the basis of their sexual orientation. Estimates indicate that insemination efforts usually cost between $250$500 per attempt, and also require follow-up ultrasounds that can run between $50 - $100.

While New York State Law currently provides for the coverage of limited infertility testing, treatment and follow-up care, this legislation does not require an insurer to cover types of infertility treatments beyond those already offered. The bill simply mandates that an insurer's infer- tility offerings be applied equally to all insureds who are part of a legally recognized relationship. Of note, the Insurance Law continues to recognize infertility standards as set forth by the American Society of Reproductive Medicine, which generally defines infertility as occurring after a twelve-month period of unprotected sex that does not result in conception.

Maryland similarly addressed this issue in 2015, passing legislation that addressed this inequity under their State law. Continuing in our own tradition of being a national leader on progressive issues, New York should now take the same step in avoiding a wrong. When it comes to issues of access to healthcare and family planning, it has always been true that the government should step in to promote and not hinder its citizens' efforts. In keeping with this, we must act to ensure equal access to reproductive services for all New Yorkers, regardless of their sexual orientation.

Legislative history

2017-18: S.322 / A.5208 2015-2016: S.8175

Fiscal implications

None

Local fiscal implications

None