Connolly, Duckworth Urge OPM to Adopt More Inclusive Family Building Policies
Today, Congressman
The current definition of infertility used by FEHB providers precludes members of the LGBTQ+ community from utilizing full health benefits, including access to assisted reproductive technology.
"We are writing to request that OPM take immediate action to update the definition of infertility within the FEHB program guidance," wrote the Members. "We request that you work closely with relevant stakeholders, including medical professionals, advocacy organizations, including the
"By adopting an inclusive definition that recognizes the full spectrum of reproductive needs and removing unnecessary barriers to coverage, we can ensure that all federal employees, regardless of their sexual orientation, gender identity, or marital status, have access to the comprehensive reproductive health care they deserve," the Members added.
In addition to Connolly and Duckworth, the letter was signed by the following Members of
The letter is endorsed by the following organizations: RESOLVE:
"Our community tells us over and over that the biggest barrier to family building is lack of adequate insurance coverage for medical care. Too often it is the definition of infertility in the insurance plan that restricts access and dictates who can, and who can't, access the medical care offered. RESOLVE:
"ASRM wholeheartedly supports full-spectrum fertility health insurance coverage for all individuals so everyone has the opportunity to have the family of their choice. In order for the Federal government to continue being an equitable and competitive employer, ARSM encourages OPM to update its definition of infertility to account for same-sex couples and single individuals. Furthermore, the current definition does not allow healthcare providers to tailor care to each individual patient's fertility journey, which creates unnecessary burdens on those seeking treatment. We thank
"We are grateful for the efforts of
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Dear Director Ahuja:
We are writing to bring to your attention a pressing matter regarding the definition of infertility used by health insurance carriers participating in the Federal Employees Health Benefit (FEHB) program. It has come to our attention that the current definition, as outlined in the 2015 technical guidance, is outdated and lacks inclusivity, particularly for the LGBTQ community.
As Members of
The current definition of infertility used by OPM for FEHB carriers states that infertility is the condition of an individual who is unable to conceive or produce conception during a period of 1 year if the female is age 35 or younger, or during a period of 6 months if the female is over the age of 35. It further states that for women without male partners or exposure to sperm, infertility is the inability to conceive after six cycles of Artificial Insemination or Intrauterine Insemination performed by a qualified specialist using normal-quality donor sperm. These 6 cycles, including the donor sperm, are not covered by the plan as a diagnosis of infertility is not established until the cycles have been completed. Intrauterine Insemination can cost between
This definition does not consider the evolving landscape of family building and the diverse needs of individuals who require fertility health care to build their families. States and employers across the country are recognizing the importance of inclusive policies and the Federal Employees Health Benefit program must keep pace with these advancements.
Recently,
In the private sector a number of companies have led the way in expanding fertility coverage to be inclusive of all family types. Companies like
We would like to highlight two specific concerns with the current definition of infertility used by OPM. First, the requirement of six cycles of Artificial Insemination or Intrauterine Insemination performed by a qualified specialist using normal quality donor sperm, while excluding other assisted reproductive technologies, is both arbitrary and unnecessarily restrictive. The number of cycles required in the definition does not take into account an infertility diagnosis that may occur when a patient is evaluated, leading to inconsistent and unequal coverage for individuals seeking alternative methods of conception. Furthermore, this policy creates unnecessary barriers and costs for LGBTQ people by excluding consideration of at-home inseminations.
Second, the definition fails to account for same-sex couples and single individuals. By limiting coverage to these individuals only after six cycles of insemination with donor sperm, we are effectively denying them access to necessary fertility treatments, placing an undue burden on their path to parenthood.
We are writing to request that OPM take immediate action to update the definition of infertility within the FEHB program guidance. We request that you work closely with relevant stakeholders, including medical professionals, advocacy organizations, including the
By adopting an inclusive definition that recognizes the full spectrum of reproductive needs and removing unnecessary barriers to coverage, we can ensure that all federal employees, regardless of their sexual orientation, gender identity, or marital status, have access to the comprehensive reproductive health care they deserve.
Thank you for your attention to this matter, Director Ahuja. As OPM continues to prioritize inclusive, family-building policies in the FEHB program, it is imperative that all federal employees have equal access to this suite of services. We look forward to your prompt response and to working together to address this important issue.
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Original text here: https://connolly.house.gov/news/documentsingle.aspx?DocumentID=4818
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