By: MarketWatch, Sarah Elizabeth Richards
If you’re looking for insurance coverage to help you have a baby, it’s not a good idea to wait and see what might replace the Affordable Care Act.
Despite the fact that the science of in-vitro fertilization is better than ever, infertility treatment has been curiously missing from the national conversation of what should be considered essential medical care.
Yet a handful of states might finally be giving reproductive health the attention it deserves: A new bill to expand infertility coverage was introduced in the New York state legislature last month and similar efforts are underway in Mississippi, New Jersey and South Carolina.
The proposed legislation comes as more companies dangle ever-generous infertility benefits packages as part of a “family-friendly” perks race intended to retain female employees. In the latest high-profile announcement, American Express now offers employees up to $35,000 in coverage for baby-making services, including IVF and medication.
Companies are increasingly filling the void because the U.S. health care system doesn’t deem treating infertility — a condition affecting 1 in 8 U.S. couples — a medical necessity. Only 15 states require that policies cover any kind of infertility benefits, and only eight mandates include IVF, which fertility doctors regard as the gold standard of treatment.
“Fertility doesn’t fall into the same category as cancer or broken bones. You don’t have to have a child to survive, so it’s not seen as health care,” says Patricia Stapleton, director of the Society, Technology, and Policy Program at Worcester Polytechnic Institute.
As a result, most patients are left to pay an average of $12,400 out of pocket for IVF, plus thousands more for medication, sperm injection and genetic testing. It’s a financial wallop that accounts for some three-fourths of patients not receiving the care they need because they can’t afford it, according to the American Society for Reproductive Medicine. Or people resort to asking their friends and family for money on crowd-funding sites with heart-tugging requests like, “Help us have a family.” In the last five years, more than 7,500 GoFundMe campaigns have raised $11.5 million, according to a calculation GoFundMe did for MarketWatch.
For companies, it turns out that helping employees have a baby is good business. Data collected from doctor rating company FertilityIQ found that women whose infertility treatment was covered by their company felt a greater sense of loyalty to their employer. “They’re incredibly grateful,” says co-founder Jake Anderson-Bialis. “Half of women said they stayed longer in a job than they normally would because of it.”
Although the number of employers offering infertility benefits has remained steady over the last few years — at 26%, according to the Society for Human Resource Management — there are two trends worth noting: A handful of companies, such as Intel INTC, -0.14% and AmEx AXP, -0.16% recently upped their coverage. And despite tech companies leading the charge to keep more women in their field, other industries are also being represented, says Anderson-Bialis, whose FertilityIQ ranked the top companies to work for as fertility patients.
For example, chemical giant BASF BASF, -1.41% added a $10,000 benefit in 2015. Insurance provider MET, -0.55% 25,000 benefit comes with a call-in advice nurse service to walk patients through the process. And Bank of America BAC, -1.66% offers unlimited coverage for IVF and medications. “When these big companies provide these benefits, they are normalizing that this is something that’s important,” says Stapleton.
Surprisingly, many employers don’t want to talk about their infertility coverage. While researching the FertilityIQ list, Anderson-Bialis said he had a hard time getting information from companies directly and often had to consult fertility clinic billing departments or ask employees to send PDFs of their benefits.
Likewise, when Barbara Collura, president of the infertility advocacy nonprofit Resolve, decided to give out an award to a fertility-friendly company at the group’s annual gala, she approached – and got turned down by – eight different companies. “I can’t even tell you how shocked I was. I wanted to say, ‘We want to tell the world how awesome you are.’ Some of them had the most amazing benefits, but they didn’t want to make them public,” says Collura. “I think that infertility is still taboo.”
Infertility assistance is also expensive, adds Anderson-Bialis, who believes that companies may not want to encourage employees to use the benefits because they don’t want to pay for them – or the subsequent parental leave.
There’s another reason companies might be shy: Many plans require employees first be diagnosed as infertile by claiming they’ve been trying to conceive for a certain amount of time to qualify for coverage. That criteria by definition excludes same-sex couples and single women. “If you’re a company that has a fertility benefit that’s not distributed to all employees fairly, there’s no way you want to talk about this publicly,” says Anderson-Bialis.
Even if the country’s biggest employers don’t want to promote their reproductive health programs, the fact that they’re offering them could send a message to legislators to make IVF a standard health insurance benefit. “When employers from their states voluntarily offer these benefits to their employees, that’s a positive influence,” says Collura, whose organization is sponsoring the New York state bill.
In the meantime, some good-old fashioned peer pressure might do the trick to get more companies to support their employees’ family-building dreams. “When we can make the statement that this is something we care about, we can create a domino effect in the market,” says Mollie O’Brien, head of compensation and benefits at BASF. “If everyone has it, then you have to have it too.”