Infertility costs will be covered by health insurance starting in 2022

BY FREDA MIKLIN -- GOVERNMENTAL REPORTER

On April 1 (no fooling) after HB20-1158 passed both houses of the state legislature with bipartisan support as the coronavirus pandemic was winding up, Governor Jared Polis signed this new law into effect that requires that “ fertility treatments be treated on equal footing with other services by insurance carriers by requiring that co-pays and deductibles and prior authorization be comparable” to other covered medical treatments because, he said, “Infertility is clearly and demonstrably a source of significant expense, as well as depression and great sadness for many Coloradans.” The most common treatment for infertility is in vitro fertilization. For those whose health insurance does not cover it, the out-of-pocket cost is usually at least $20,000.

Taking into account the coronavirus crisis and the potential negative impact of this new required coverage to the cost of health insurance, Polis said in his signing statement, “I will not sign any other insurance mandate bills passed by the General Assembly during the 2020 session except where there is an urgent need for additional benefits related to COVID-19.”

The new requirement, which takes effect for health benefit plans issued or renewed in Colorado on or after January 1, 2022, covers the diagnosis and treatment of infertility and fertility preservation services. It prohibits the imposition of any limits for fertility medications that are not applicable to coverage for other prescription medicines. It also prohibits the imposition of deductibles, copayments, coinsurance, benefit maximums, waiting periods, or other limitations that are not applicable to other medical services covered under a regular health insurance plan.

Religious employers are allowed to request an exclusion from offering “infertility coverage in a health benefit plan offered by the religious employer if the coverage conflicts with the religious organization’s bona fide religious beliefs and practices.”

There is also a provision that Polis asked to have added to the new law to protect the state’s general fund in the event that the state is forced to pick up any increased costs because fertility treatment is deemed to be a new mandate under the Affordable Care Act. If that occurs, “the provisions of the bill impacting the small group and individual market will not take effect.”

According to the National Conference of State Legislatures, sixteen other states, Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia, require some level of infertility coverage be provided to or offered to customers.

All Democratic legislators who were present for the final vote in both houses of the general assembly voted for the bill. Also voting in favor were Republicans Mark Baisley (HD39), Don Coram (SD6), Larry Crowder (SD35), Lois Landgraf (HD21), Kevin VanWinkle (HD43), and Perry Will (HD57).

Fmiklin.villager@gmail.com