The Business Council opposes A.7478-A (Simotas) which would mandate group insurance coverage of in vitro fertilization (IVF) and other fertility treatments. While we recognize the emotional nature of the bill’s subject, the costs associated with such a mandate would be significant, in a state with already high premium costs and astronomical state-imposed taxes and assessments. In a season of double-digit premium increase requests, policy-makers need to be ever more mindful of the financial burden that they are putting on New York’s workers and employers who will have to shoulder this massive socialization of costs.
Nationally, one in eight couples has trouble getting pregnant or sustaining a pregnancy, which breaks down to at least 441,000 New Yorkers who may potentially desire to utilize IVF and other treatments. The American Society of Reproductive Medicine (ASRM) lists the average price of an in vitro fertilization (IVF) cycle in the U.S. to be $12,400. (ASRM does not qualify if this includes medications). Such medications can include;
- Average cost of an IUI cycle: $865; Median Cost: $350
- Average Cost of an IVF cycle using fresh embryos (not including medications): $8,158; Median Cost: $7,500
- Average additional cost of ICSI procedure:$1,544; Median Cost: $1,500
- Average additional cost of PGD procedure: $3,550; Median Cost: $3,200
- (Note: Medications for IVF are $3,000 $5,000 per fresh cycle on average)
What's more, of the 15 states that require insurers to offer some coverage for fertility treatments, only 8 mandate IVF coverage. State mandates on private insurance vary; most have limits on the numbers of attempts and life-time monetary limits. Even Massachusetts, which has the most generous IVF mandates, dictates certain limits based on the age of the woman attempting to become pregnant. This legislation has no limits whatsoever on frequency of treatment age or cost.
The effects of an open-ended mandate on costs are exacerbated by the fact that the success rates for infertility treatments vary widely, depending on a woman’s age and the specific fertility problems involved. According to the CDC, women under age 35 who complete one treatment cycle have a 40 percent chance of giving birth. By the time a woman reaches 43 or 44, the figure drops to 5 percent.
Unlike other treatments and procedures covered by health insurance, IVF remains an elective procedure. Despite this, many employers have, for various reasons, decided to offer some form of fertility benefit to their employees. According to a Mercer L.L.C. November 2015 study, 60% of employers with more than 500 workers offer some type of fertility benefit, up from 54 percent in 2008. About one-third of those employers cover fertility drug therapy, 24% cover IVF, and 23% cover artificial insemination. New York’s employer’s should have the right to decide whether or not such a benefit is appropriate and affordable for their business.
There is no doubt that IVF places a significant cost on families that choose to utilize the procedure. There are a number of proposals to help families shoulder some of that burden. New York’s US Senator Kirsten Gillibrand has proposed a 50% Infertility Tax Credit and others have similar proposals. In mandating coverage of IVF, we are simply shifting the cost burden to other families. When considering such expensive mandates on private insurance, New York’s Legislators should remember that the resources of New York’s job-creators and families are always limited. Asking New York’s families and small businesses to pick up the hefty tab for elective medical procedures for some is not only the wrong course of action but it is just plain wrong.
For these reasons The Business Council respectfully opposes A.7478-A (Simotas).